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Copyright 1999 


Dorothy Jean Hawthorne 

Dedicated to 
The Loving Memories 
of my Father 



I wish to acknowledge the young girls and their mothers 
for sharing their life- lived experiences about a private and 
sensitive topic, menarche. I am especially grateful to my 
early maturing daughter, Nathan' ette Burdine, for inspiring 
my interest in menarche as a research focus. I thank my 
family and friends for their continued support throughout 
this lengthy doctoral process. 

My deepest sincere thank you is extended to Dr. Richard 
Lutz and the members of my supervisory committee including 
Dr. Hossein Yarandi , Dr. Faye Gary, Dr. Sharleen Simpson, 
Dr. Felix Berardo, and Dr. Joe Feagin. Often I encountered 
one obstacle after another as I struggled to maintain my 
focus on the goal of completing this task. Abandoning this 
project, however, was impossible with the strong support 
offered by the University of Florida's Graduate School 
through Dr. Richard Lutz and the members of my supervisory 
committee. I thank you. 

Dr. Hossein Yarandi served as my mentor long before 
officially assuming the advisor and supervisory chair roles. 
I wish to acknowledge his years of kind guidance, patience, 
and friendship. Dr. Faye Gary has been my shining light at 
the end of a lonely and dark tunnel for the final twelve 


weeks of this project. It has been an honor to work closely 
with a graceful and focused professor as Dr. Gary. She is a 
joy, and I am deeply indebted to her. 

I wish to acknowledge Dr. Felix Berardo as my 
counselor-of -reality. He is a person of wisdom, and he 
served as my voice of reason throughout my doctoral 
experience at the University of Florida. I appreciated his 
direct and taciturn ways of sharpening my insight into 
issues that truly mattered. 

There is no question that most African Americans know 
what it means to be black while living in the United States. 
Of course I knew this, at least I thought I did, until I met 
Dr. Joe R. Feagin. I wish to acknowledge Joe's professional 
and candid analysis of racial -ethnic situations that have 
either directly and/or indirectly influenced my personal and 
professional lives. Joe helped to hone my critical thinking 
about how the literature and media portray African American 
females. With Joe's help, I was able to critically evaluate 
and present literature that addressed the life of African 
American females at menarche. 

Lastly, I dedicate this work to my father, Nathaniel 
Hawthorne, Sr., and all that he stood for. Only through 
memories of his image as a strong, loving, and devoted 
father was I able to persevere to the completion of this 
task. I wish to acknowledge my love for him, and my 
commitment to making him proud of having me as a daughter. 








Background of the Problem 2 

White Females 3 

African American Females 6 

Parents 8 

Statement of the Problem 11 

Purpose of the Study 13 

Research Questions 14 

Theoretical Perspectives 15 

Symbolic Interactionism 16 

Phenomenologic Humanism 19 

Significance of the Study 22 

Definition of Terms 24 

Origin of the Study 25 

Assumptions 29 

Scope of the Study 3 

Delimitations 30 

Limitations 31 

Overview of the Remaining Four Chapters 32 


Age of Menarche Onset 33 

Chronological Age at Menarche 34 

Biophysiological Thesis 37 

Sociobiological Thesis 39 

Cognition in the Child 42 

Information Processing 43 

Storage and Use of Information 44 

Educational Preparation 45 

Limited Educational Preparation 46 

Mothers as Teachers About the Menarche 47 


Responses to Menstruation 49 

Psychological Responses 50 

Self -Concept 57 

Personality Characteristics 

of Maturing Females 59 

Familial Status 61 

Menarche to Sex and Pregnancy 62 

Peer Relationships 65 

Summary 67 


Research Design 68 

Sample 71 

Feasibility Study 71 

Family Types 72 

Socioeconomic Status (SES) 73 

Sampling Procedures 75 

Demographic Information 79 

Scientific Integrity and Rigor 82 

Protection of Human Subjects 91 

Data Collection 92 

Data Analysis and Verification 95 

Summary 97 


Organization of the Chapter 98 

Symbolic Bleeding 99 

Philosophical Beliefs 99 

Emotional Responses 108 

At Another Time 119 

Sexual Sensuality 126 

Private Business 132 

Regulating Sexual Behavior 137 

Gender Sexuality Scripting 138 

Cross - Sex Segregation 142 

Parental Supervision 147 

Good Company 153 

Managing Menstrual Flow 156 

Mother's Significance 156 

Comfort Measures 162 

Hygienic Measures 165 

Preparation for Subsequent Flows 171 

Summary 173 


Organization of the Remainder of the Chapter 178 

Living Through Private Time 178 

Symbolic Bleeding 180 

Regulating Sexual Behavior 183 

Managing Menstrual Flow 184 


Self -Concept 186 

Self-image 187 

Self -Esteem 190 

Recommendations 194 

Implications for the African American 

Family Literature 194 

Implications for Nursing 196 

Implications for Further Research 197 










Table page 

3-1 Profile of Feasibility Sample's Types of 

Families and Socioeconomic Classes 74 

3-2 Demographic Profile of the Young Girls 

Indicating ID Number, Age, Tanner's Stage, 

Time in Study, and Height and Weight 83 

3-3 Demographic Profile of the Parents Including 
ID Number, Mother's Age, Father's Age, 
Mother's Education, Father's Education, 
and Household Income 84 

3-4 Profile of the Young Girls' Families 

Including Family Type, Socioeconomic 

Status and Number in Household 85 

3-5 Profile of Family Types and Socioeconomic 

Classes According to Hollingshead 1 s Index 
(Gilbert & Kahl , 1993) 86 

3-6 Profile of Biological Father's Presence 

and Absence in the Home and Socioeconomic 

Class Stratification 86 

3-7 Frequency and Percent of Variables Tanner's 
Stage, Family Type, and Socioeconomic 
Status (SES) 87 

3-8 Summary Measures of the Demographic Variables 88 


Abstract of Dissertation Presented to the Graduate School 

of the University of Florida in Partial Fulfillment of the 

Requirements for the Degree of Doctorate of Philosophy 



Dorothy Jean Hawthorne 

August 1999 

Chairperson: Hossein Yarandi, PhD 
Major Department: College of Nursing 

A female's first menstrual flow (menarche) is not only 

a physical experience, but an influential social, 

psychological and familial event. The social psychological 

responses of individuals from various ethnocultural and 

socioeconomic backgrounds to influential events are 

significant to the professional practice of mental health 

nursing. The positive, negative, and mixed effects of 

menarche in middle- class European (White) American females 

have been well researched as compared to other ethnocultural 

and socioeconomic groups. Theoretical formulations for the 

social psychological responses of African (Black) American 

females at menarche were prepared. The qualitative case 

study approach was used to: (1) discern the thoughts, 

feelings, beliefs, practices, and social interactive 

behaviors of African American females at the time of their 
menarche; (2) learn the social psychological responses and 
practices of African American mothers to the onset of their 
daughters' menarche; and (3) posit a core theme to 
substantially describe and explain the social psychological 
and familial responses of menarcheal aged females belonging 
to the African American ethnocultural group. 

Thirty participants (15 mother -daughter dyads) were 
interviewed. The 9/10 -year-old female was the invited age 
group of young girls for this study. Participants were 
informally interviewed in a 45- to 60 -minute audiotaped 
mother -daughter session. The data were analyzed by 
performing a cross comparison of the interview responses for 
evolving themes from the multiple case studies. Living 
through private time was the substantial theme inductively 
discovered from the data. It is anticipated that the 
results of this study will add to the knowledge of nurses 
and all other health care professionals about the social 
psychological and familial status of 9- and 10 -year-old 
African American females at the time of their menarche. 



An increasing number of African American females are 
menstruating by ages 9 and 10 years old (Doswell & Millor, 
1993; Herman -Giddens et al . , 1997; MacMahon, 1973; Marshall 
& Tanner, 1969) . However, scientific data collection on the 
social psychological and familial experiences of young 
African American females after their menarche is rare (Grief 
& Ulman, 1982; Lee, 1994; Lee & Sasser-Coen, 1996). 

Most investigators collect behavioral data from 
menstruating females several months and years beyond the 
actual onset of menarche (Amann-Gainotti, 1986; Caspi & 
Moffitt, 1991; Du Toit, 1987; Holmbeck & Hill, 1991; Lee & 
Sasser-Coen, 1996; McGrory, 1990; Phinney, Jensen, Olsen, & 
Cundick, 1990; Rierdan & Koff, 1991; Scott, Danette, Panizo, 
& Roger, 1989) . One barrier to data collection is that once 
young girls have had their first menstrual flow, they move 
further away from this initial event and other childhood 
experiences (Belsky, Steinberg, & Draper, 1991; Brooks-Gunn, 
Warren, Rosso, & Gargiulo, 1987; Bullough, 1996) . As time 
passes, girls will gain increasing cognitive skills 
(Flavell, Miller, & Miller, 1993; Klahr & Wallace, 1976; 
Piaget and Inhelder, 1996; Siegler, 1996) and other 

sociocultural forces interact to shape their life 
experiences (Bronfenbrenner, 1989; Gilligan & Murphy, 1996; 
Hetherington, 1972;). Menarche, as a unique experience, 
will blend with other life events as it takes on different 
meanings for each individual (Berger & Luckmann, 1966; 
Blumer, 1969; Hewitt, 1994) . As a result of physiological 
life changes, the "self" of postmenarcheal females is 
reconstructed, and is based on repeated social psychological 
life experiences with menstruation. Other life events and 
an increasing cognitive development help to shape young 
girls' perceptions about the world around them. 

A greater repertoire of knowledge about the physical, 
social, psychological, and familial effects of menarche as 
perceived by African American menarcheal females is needed. 
Nurse researchers can contribute to this knowledge base by 
qualitatively studying the phenomenological worlds of 
younger African American girls ages 9 to 10 years at 
menarche. Further, this knowledge can contribute to 
improving the physical and social psychological health 
outcomes of African American females. 

Background of the Problem 

The background information of the problem relative to 
this study is presented under three subheadings: (1) White 
females, (2) African American females, and (3) Parents. 
Literature on the social psychological experiences of the 
White female is presented first. Overtime, researchers have 

investigated the social psychological experiences of White 
females; that literature is more extensive. 
White Females 

The secular trend shows a decline in age at the onset 
of menarche for many European (White) American females. 
Over the last 100 years the age of menarche onset decreased 
from 17 to about 12.8 years of age (Golub, 1992; Herman - 
Giddens et al . , 1997; Tanner, 1978). Previously, this early 
age of menarcheal onset was associated with "superior racial 
stock and physical traits" (Stone & Barker, 1939, p. 29) and 
"the most favorable living circumstances" (Smart & Smart, 
1972, p. 496). More recent sociobiological reports suggest 
environmental life stressors in the middle-class White 
female are associated with early menarcheal onset (Belsky, 
Steinberg, & Draper, 1991; Surbey, 1990; Wierson, Long, & 
Forehand, 1993) . 

For many White middle-class American girls 9 and 10 
years of age, the first menstrual flow (menarche) is an 
emotionally traumatic and a private life event (Chadwick, 
1992; Lee, 1994; Logan, 1980; Stattin & Magnusson, 1990; 
Williams, 1990) . As a normal response to the increased 
levels of gonadotropin (reproductive and sex) hormones 
during the late stage of puberty, menarche involves pain and 
vaginal blood flow (Guyton & Hill, 1996). The condition or 
state of a female's reproductive body part is a private 
matter (McKinney, 199 8) . Privacy and secrecy are major 

issues for families (Berardo, 1998; Brown- Smith, 1998; 
Weigel-Garrey, Cook, & Brotherson, 1998) and their 
developing daughters of ages 9/10 years (Smith, 1997; Van 
Manen & Levering, 1996) . As a tradition, in the United 
States, sexual body parts are considered private and are not 
publicly exposed or discussed (Berardo, 1998; McKinney, 
199 8; McKinney & Sprecher, 19 89) . 

Seldom do schoolage girls discuss their menarche with 
individuals. The exceptions, however, are those young girls 
who will discuss menarche with parents, a favorite sister, 
or a close friend (Notman, 1992; Petersen, 1983). For the 
middle-class White American schoolage girl, it is common 
practice to refrain from joyfully celebrating or publicly 
broadcasting menarche arrival, since it is a private matter 
imbued with sensitive emotions (Caspi, Lynam, Moffitt, & 
Silva, 1993; Golub, 1992; Hyde, 1996). 

Several empirical reports exist on younger 9/10 -year- 
old White girls' negative emotions to menarche including 
fear, disgust, nervousness, shame, embarrassment, and 
humiliation (Grief & Ulman, 1982; Notman, 1992; Stattin & 
Magnusson, 1990; Williams, 1990) . A manifestation of 
negative emotions to menarche onset in younger age, or early 
maturing, girls support the thesis that menarche is a 
stressful and traumatic developmental event (Clark & Ruble, 
1978; Jones & Mussen, 1958; Kornfield 1990; Malmquist, 1972; 
Rierdan & Koff , 1980; Surbey, 199 0) . 

The self-esteem and self-image of White girls less than 
12 years old is lower at menarche as compared to older age 
White girls at the time of their initial menstruation 
(Delaney, Lupton, & Toth, 1988; Papini & Sebby, 1987; 
Richards, Boxer, Petersen, & Albrecht, 1990; Slap, Khalid, 
Paikoff , Brooks-Gunn, & Warren, 1994) . There are research 
reports that show middle-class White girls are more 
accepting of menarche when they understand it, and that they 
experience less negative emotions at its onset if it is 
cognitively understood (Danza, 1983; Lee, 1994; Moffitt, 
Caspi, Belsky, & Silva, 1992; Petersen, 1983; Rierdan & 
Koff, 1985; Simmons, Blyth, VanCleave, & Bush, 1979; Grief & 
Ulman, 1982) . These young girls may not be ready to 
understand the physiological processes of menstruation and 
are less likely to have cognitive awareness about the 
sociocultural meaning of menstruation (Chi & Klahr, 1975; 
Flavell, Miller, & Miller, 1993; Kail, 1990). 

White girls who menstruate at an age less than 12 
years, early-maturers, tend to initiate sexual intercourse 
sooner than older age menarcheal girls (Bagley, 1997; Costa, 
Jessor, Donovan, & Fortenberry, 1995; Phinney, Jensen, 
Olsen, & Cundick, 1990) . Girls of 9 to 10 years of age have 
not yet developed higher levels of cognitive reasoning 
(Piaget & Inhelder, 1996) , which places them at risk during 
their sexual decision-making (Ward & Overton, 1990) . 

Young girls who engage in sexual intercourse risk 
becoming pregnant. The highest pregnancy rate in the United 
States is reported among those girls who start menstruating 
at an early age (Jaccard, Dittus, & Gordon, 1998; Leite, 
Everardo, Buoncompagno, Leite, Battistori, 1994; Millstein 
et al., 1992; Morgan, Chapar, & Fisher, 1995; Rodriquez & 
Moore, 1995) . Early childbearing can be a traumatic 
experience for developing schoolage girls. Generally, there 
is a disruption in education, income is meager, and health 
complications are not unusual (Freeman & Rickels, 1993) . 
Also, higher rates of premarital sex increase the risk for 
contracting sexually transmitted diseases (Dean, Ducey, & 
Malsk, 1997) . 
African American Females 

A recent national study done by the American Academy of 
Pediatrics shows African American girls start menstruating 
at the average age of 12.16 years (Herman -Giddens et al . , 
1997) . Moreover, many are experiencing menarche as early as 
8 and 9 years of age (Herman -Giddens et al . , 1997; Powers, 
Hauser, & Kilner, 1996) and are initiating sexual 
intercourse earlier than their White counterparts (DuRant & 
Seymour, 1990; Vinovskis, 1988; Williams, 1991; Zabin & 
Hayward, 1993) . 

The biophysiological model attributes the early age of 
menarcheal onset in African American girls to genetics and 
improved nutrition and living conditions (Herman -Giddens et 

al . , 1997). A few sociobiological investigators, however, 
use results from correlational research studies carried out 
with middle- class White females of divorced parents to 
report that the early onset of menarche is associated with 
environmental stressors (i.e., absent-biological-father, 
low- income homes, uneducated parents; poor parenting skills) 
as compared to biologically determined changes (Belsky, 
Steinberg, & Draper, 1991; Wierson, Long, & Forehand, 1993) . 

Many African American children are raised by a single - 
parent, in underresourced homes, and in impoverished 
conditions (Beeber, Hendrix, Taylor, & Wykle, 1993; Feagin & 
Feagin, 1996; Hacker, 1992). Their environmental conditions 
are unlike those of most White females (Comer & Poussaint, 
1992; Feagin & Feagin, 1996) . Also, the "culture-of - 
poverty" thesis (Moynihan, 1967) and adverse social 
psychological results obtained from correlational research 
studies carried out on middle-class White samples can 
sometimes be inappropriately applied to African American 
children and their families (Billingsley, 1992; Demos, 1990; 
Feagin & Feagin, 1996; Graham, 1992; Taylor, Chatters, 
Tucker, & Lewis, 1990; Willie, 1985). Lastly, qualitative 
empirical reports from the voices of young African American 
girls and their parents that describe their emotional 
responses to menarche are yet to be researched. 

African American, and other non-White, schoolage girls 
are less likely to be prepared for menarche as compared to 

Whites (Amann-Gainotti, 1986; Doswell & Millor, 1993; Du 
Toit, 1987; Scott, Danette, Panizo, & Roger, 1989). 
Empirical data collected on White samples suggest that the 
less informed girls experience more negative feelings about 
menarche than the more informed girls. Yet, the empirical 
reporting of menarche for African American females as a 
negative, stressful, or traumatic emotional event is not 
documented in the literature (Doswell, Millor, Thompson, & 
Braxter, 1998; Grief & Ulman, 1982; Scott, Danette, Panizo, 
& Roger, 19 89) . Further, little has been written about how 
African American females approach the onset of menarche 
regarding privacy and secrecy (Dashiff, 1992; Doswell & 
Millor, 1993; Grief & Ulman, 1982; Scott, Danette, Panizo, & 
Roger, 1989) . Based on these findings, then, there is a 
need for nurses to empirically study the social 
psychological responses of young African American girls to 
their first menstrual flow, menarche. 

Parents tend to be emotionally stressed by the 
appearance of menarche in their child of 9 to 10 years of 
age (Bullough, 1996; Chadwick, 1992; Hill, Holmbeck, Marlow, 
Green, & Lynch, 1985; Holmbeck & Hill, 1991) . For many 
parents, menarche means reproductive capabilities and sexual 
sensuality and eroticism. The expected behavior for a 9/10- 
year-old girl is that she lives with her parents, attends 
elementary school, and participates in nonsexual activities 

(Baumrind, 1993; Bronf enbrenner, 1997) . However, there is a 
challenge to such expectations when physiological production 
of gonadotropin hormones stimulates puberty and the 
menstrual flow begins, breasts are evident, pubic hair 
appears, and the sensual curving of waist and hips is easily 
observed. Most parents are aware that early maturers are 
capable of producing babies even though these young girls 
are not prepared to care for the baby nor themselves. These 
physical changes tend to trouble parents as they observe 
their young female child's body transcend to womanhood. 

Menarche, in most cultures of the world, symbolizes a 
transition from girlhood to womanhood (Lee, 1994; Weideger, 
1998) . Womanhood implies maturity, heterosexual sensuality 
as well as availability, and reproductive capability (Hyde, 
1996; Rubin, 1990) . However, a focus on the young girl, 
reveals a different set of practices. A person of 9 to 10 
years of age is a child, not an adult or a woman (Rubin, 
1990) . After all, childhood is equated with sexual 
inactivity and nonreproductive capability (Bronf enbrenner, 
1997; Dean, Ducey, Malsk, 1997; Freud, 1933/1964; Hyde, 
1996) . 

Some researchers note that sexual urges and desires of 
young girls are not latent or quiet as Freud would have many 
to believe (Jaccard, Dittus, & Gordon, 1998) . Further, 
Erikson's (1963) psychosocial axioms support the position 
that young girls are busy, industrious people, working to 

receive rewards from significant adults. They are more 
likely to experience a sense of success and avoid feelings 
of inferiority and failure if they are successful at their 
industriousness (Erikson 1963). These theoretical 
formulations can be challenging when menarche appears before 
age 12 years. 

Developing children look for adults to direct, guide, 
and set limits on their activities and behaviors (Baumrind, 
1993; Bronfenbrenner, 1997). At the onset of menarche, 
developing females tolerate less behavioral control and 
limit- settings (Doswell & Vandestienne, 1996; Holmbeck & 
Hill, 1991). As the newly menstruating female struggles for 
independence, parents' fears of dating, sexual pressure, and 
pregnancy force them to place greater restrictions on their 
activities outside of the home environment. This increased 
parental control and restrictions at the critical time of 
menstrual onset can create parent -child conflict (Doswell & 
Millor, 1993; Holmbeck & Hill, 1991; Steinberg, 1988). 
Mother -daughter relationships have the potential to suffer 
the longest with negative impact (Gilligan & Murphy, 1996; 
Hill, Holmbeck, Marlow, Green, & Lynch, 1985) . 

However, some mother -daughter relationships are not 
always jeopardized (Rich, 1990) . Parents who are not 
threatened by their daughter's emotional need to 
differentiate and to become independent tend to have a 
stronger relationship with their daughters, show affectional 


bonding, and use effective problem- solving skills (Doswell & 
Millor, 1993; Holmbeck & Hill, 1991). The onset of 
menstruation as an indisputable sign of maturity, erotic 
interest, and reproductive capability of the young female 
challenges past health and mental health knowledge and 
approaches. Inasmuch as parents may react positively or 
negatively to their early maturing daughter's menarche, 
contemporary theoretical knowledge of human behavior 
supported by empirical data is essential for more accurate 
formulations about young girls (Meleis, 1997) . 

Statement of the Problem 
Although there are insightful research reports about 
the influence of menarche on White females' social, 
psychological, and familial behavior, most earlier 
investigators failed to include African American females and 
their parents in conceptual domains. African American 
females were not, as a rule, included in their samples. 

Research suggests that younger age White girls are more 
likely to experience negative emotional responses toward 
menarche, and are less cognitively prepared than the older 
girls. On the other hand, African American girls who 
experience menarche at a young age are also poorly prepared 
cognitively for its onset. However, little research exists 
that explicates experiences and emotional responses of 
African American girls to this normal and universal 
developmental event. The life experiences surrounding 

menarche and mental health issues of young non -White 
developing girls and their parents from other ethnocultural, 
socioeconomic, and family types have received little 
attention from previous investigators. 

Researchers who studied menarcheal experiences most 
frequently used the quantitative correlational design with 
questionnaires for data collection (Kornfield, 1990; Belsky, 
Steinberg, & Draper, 1991; Grief & Ulman, 1982) . These 
researchers collected data from their subjects anywhere from 
2 months to 64 years after the onset of menarche. Further, 
many reported studies focused on the meaningful menarcheal 
experiences of middle-class White American girls living in 
nuclear- family settings with their biological parents and 
siblings. Results from correlational studies, which operate 
under the positivistic paradigm, are used by many 
researchers to report a cause -effect of human behavior 
(Kuhn, 1962) . Confounding of age, cohort, onset of 
menarche, and time period of data collection are major 
problems with these correlational designs (Lincoln & Guba, 
1985; Marshall & Rossman, 1999). 

Theorists tend to formulate concepts that are congruent 
with their personal lives and/or the sociopolitical climax 
of their time (Meleis, 1997; Morrison, 1992; Priest, 1991). 
Widely used theoretical perspectives that were developed 
prior to the 1960s reflect a masculine-dominate 
philosophical belief and life-practices (Best & Kellner, 

1991) . Before the 1960s, theoretical underpinnings often 
included Freud's (1933/1964) psychoanalytical theory of 
psychosexual development, which was used by many researchers 
and scholars to present empirical findings and discussions 
about females' mental health issues related to menstruation 
(Fenichel, 1945). Emphasis was placed on Freud's castration 
complex (Deutsch, 1944) and penis -envy theme (Thompson, 
1942) in order to describe the emotionally ill -state of 
women during menstruation. Steinem (1983) noted that male 
humans have grounded entire cultures on the thesis that 
penis -envy is natural for women. 

The 1990s is a different time-period with varied groups 
of theoreticians who espouse multiple theories about mental 
health in general and behavioral responses to menarche in 
particular. As a result, contemporary researchers and 
thinkers use other perspectives, such as feminism to present 
information about females' issues (Gary, Sigsby, & Campbell, 
1998) . Nevertheless, few scholars use symbolic 
interactionism and phenomenologic humanism to describe the 
verbal reports of the life- lived experiences of young 
African American females under the extended qualitative case 
study approach at the time of their first menstrual flow. 

Purpose of the Study 
The purpose of this study is to (1) capture the social 
psychological responses of African American girls aged 9/10 
years to their first menstrual flow, menarche, (2) 

articulate the social psychological responses of African 
American parents to their young daughter's menstruation, (3) 
construct a core social psychological theme to substantively 
describe lived experiences of African American families to 
young girls' menarche, and (4) recommend suggestions for 
culturally sensitive interventions that could be developed 
for and tested among African American girls, ages 9/10, who 
are at menarche. 

Discovery of a core social psychological theme for 
theoretical formulations around menarche was a major aim of 
this study. While theoretical knowledge is essential to 
nursing science and practice Meleis (1997) asserts that 
clinical data gleaned from nursing practice is one of the 
most significant, but neglected source for theory 

Research Questions 

The major focus of the qualitative researcher using the 
case study method is on "how" or "why" questions about a 
human life event (Yin, 1994) . Once data collection starts, 
however, many questions may surface as the study grows and 
as various topics evolve around the original phenomenon of 
interest. The major research questions of interest at the 
outset of this project were: 

1. How do African American girls ages 9 and 10 years 
old think and feel about starting their first menstrual 


2 . How do African American parents react to the 
menarcheal onset and reproductive capability in their 
daughters who are 9 and 10 years old? 

3. How do 9/10 -year-old African American girls manage 
the care of their first menstrual flow? 

4. What changes manifest in African American family 
members' relationships with each other around the onset of 
menarche in girls ages 9 and 10 years? 

Theoretical Perspectives 
"Living through private time" was the core social 
psychological theme uncovered from the data for a set of 
theoretical formulations. This core theme is supported by 
the conceptual domains of symbolic bleeding, managing 
menstrual flow, and regulating sexual behavior. Living 
through private time was developed from interview data of 
the phenomenological lived experiences of African American 
families with newly menstruating 9/10 -year-old daughters. 
Only after the perceptions, behaviors, and lived experiences 
of African American girls to menarche are clearly understood 
can theories be formulated for a set of cannons needed to 
develop context -specific interventions by nurses and other 
health care providers. 

Symbolic interactionism and phenomenologic humanism are 
the two major theoretical perspectives used to help 
interpret participants' interview responses about their 
life- lived experiences surrounding menarcheal onset in the 

9/10 year old African American females. Qualitative 
researchers often use more than one theoretical framework to 
descriptively present participants' statements (Marshall & 
Rossman, 1999) . 

Specifically, symbolic interactionism is a social 
psychological theory often used by researchers to illuminate 
the meanings research participants assign to interested 
phenomena (Blumer, 1969; Gubrium & Holstein, 1997) . On the 
other hand, phenomenologic humanism, with roots in Heidegger 
philosophical thoughts, is a type of third- force personality 
theory (DeCarvalho, 1991; Rahilly, 1993) used to 
qualitatively describe participants' lived experiences about 
an event or an occasion. 

Blumer' s (1969) symbolic interactionism and 
phenomenologic humanism grounded in Heidegger's (1962) 
philosophical thoughts are qualitative research approaches 
as well as theoretical perspectives. In this study, 
symbolic interactionism and phenomenologic humanism are used 
as philosophical positions for theoretical underpinnings of 
participants' meaningful experiences to menarche, a normal, 
though stressful developmental life-event in 9/10-year-old 
African American girls. 
Symbolic Interactionism 

Symbolic interactionism is an American sociological 
perspective with roots in the philosophy of pragmatism 
(Shalin, 1986) . According to Hewitt (1994) pragmatist 

scholars such as Charles S. Pierce, William James, John 
Dewey, and George Herbert Mead view living things as 
attempting to make practical adjustments to their 
surroundings. That is, all living organisms are oriented to 
meeting the demands of their environments in practical ways. 
Pragmatists see knowledge as continually confronting tests 
of its usefulness. Knowing and acting are intimately 
linked; that is, humans act on the basis of their ideas or 
knowledge about the world. The reality of the world is not 
merely something that is out there and waiting to be 
discovered; instead, it is actively created as people act in 
and toward the world. 

For Herbert Blumer (1969) , symbolic interactionism is a 
social psychological theory of human social interaction. 
Symbolic interactionism, also, is an approach to the study 
of human life and conduct in response to objects, events, 
situations, conditions, and circumstances. Blumer gives 
four central conceptions of symbolic interactionism. The 
first states that humans behave toward things based on their 
ascribed meanings of things. The second premise supports 
the theme that the meanings of things are learned through 
social interaction with one's fellow humans. Third, humans 
modify learned meanings through an individual interpretative 
process as they use and deal with encountered things, 
people, objects, and events. The fourth conception states 
that the complex interlinkages of human acts are nonstatic. 

These premises are guided by the belief that individuals are 
active organisms who cope with and handle "meanings" as they 
adjust to their particular surroundings and environments. 
In social interactions, people use language, symbols, and 
gestures to create meanings within their sociocultural 

A major central concept in symbolic interactionism is 
the self (Blumer, 1969; Mead, 1934). The self emerges from 
social experience, is dynamic, and is capable of change. 
The self, then, is not merely a passive reflection of social 
norms. Social experience, however, is the exchange of 
symbols and is essential to the development of the self. 
According to Mead (1934) , the self is composed of two 
components, the I and the me. The self is subject in that 
it can initiate social action. Mead claims humans are 
innately active and spontaneous, and he calls this 
subjective element of the self the I. Second, the self is 
object because, taking the role of another, humans form 
impressions of themselves. Mead refers to this objective 
element of the self as the me. All social experience begins 
with someone initiating action (the I-phase of self) and 
then guiding the action (the me-phase of self) through 
reflectively taking the role of the other. The fact that 
people are able to see themselves through others produces 
evidence that the self has two components (Hartup, 1992; 
Hewitt, 1994; Mead, 1934). 

As many selves exist in a society as there are human 
beings (Harter, 1990) . A group of humans contribute to the 
general meanings of the human condition within their 
sociocultural context (Scarr & McCartney, 1983) . However, 
meanings ascribed by the group may change from one person to 
another, from one time period to another, and from one 
context to another. As a result, a general agreement about 
meanings within any given group of individuals does not stop 
a person from acting toward objects or things based on a 
different set of meanings. Therefore, it is essential that 
nurses empirically secure contemporary knowledge and 
understanding of the various meanings attributed to menarche 
by individuals in a multicultural society. 
Phenomenological Humanism 

Phenomenological humanism is a post- 1950s "third- force" 
personality theory and an American brand of existential 
psychology (DeCarvalho, 1991) . Dissatisfied with the study 
of human life experiences through the psychoanalytic and 
behavioral learning theories, Gordon Allport (cited in 
DeCarvalho, 1991) called for a new and broader type of 
humanistic psychology. Along with Allport, phenomenological 
humanism is exemplified in the work of Carl Rogers, Abraham 
Maslow, and Rollo May (Polkinghorne, 1989; Rahilly, 1993). 
As a philosophy, phenomenology was founded by Edmund 
Husserl at the turn of the century and furthered developed 
as an existential philosophy by his student, Martin 

Heidegger (1962) . The subject matter of phenomenology began 
with consciousness and experience, but Heidegger expanded it 
to include the human life world. For Heidegger (1962) , 
phenomenology is a philosophical school of thought that 
focuses on subjective experience and seeks to make visible 
the nature and meaning of Being. Being is the being of 
whatever is and human being is just one presentation of 

Humans come to understand some of the possible meanings 
of Being through their experiences of the world and being 
within it. Everyday lived experience is the focus of 
attention. The concern is to clearly present human lived 
experience since this is the place where "meaning" resides 
that individuals give to events. Because human lived 
experience is "everyday" and seems ordinary, much of its 
meaning remains hidden, and may even be characterized as 

Heideggerian phenomenology holds that individuals' 
foundational mode of existing as persons is in the 
interpretation and understanding of the reality that 
surrounds them. Understanding is grasping one's own 
possibilities for being, within the context of the world in 
which one lives. Understanding, then, is a mode of being. 
Understanding is rendered explicit by interpretation, that 
is, in language. Language does not merely represent a 
person's way of being, it discloses what it is to "be." 
Language is a mode used by human beings which unveils Being. 

The Association of Humanistic Psychology, founded in 
1962, adopted four interrelated principles to guide their 
pursuits (DeCarvalho, 1991) . The first states the 
experiencing person is of primary interest. Humans are the 
subjects in real -life events and circumstances, rather than 
mere objects of study. 

The second principle deals with human choice, 
creativity, and self -actualization as the preferred topics 
of investigation. Phenomenological humanists argue that the 
study of psychologically crippled people has led to a 
crippled psychology, while the study of lower organisms has 
yielded an incomplete psychology, devoid of consciousness. 
It is believed that the focus should be on wholesome and 
healthy individuals, people who are creative and fully 
functioning. Growth, rather than mere adjustment, is the 
criterion of health. 

Third, meaningfulness must precede objectivity in the 
selection of research problems. Previously, much research 
was centered more on methods rather than broad problems. 
Research topics were often selected because objective and 
convenient methods became available. However, research 
projects should be undertaken because they are significant 
and pertinent to human life issues. There is a need to 
study the important issues of people's lives. 

The fourth and last principle is that the ultimate 
value is placed on the dignity of the person. Humans are to 

be accepted as unique. Researchers must understand people. 
Phenomenology is interested in elucidating both that which 
appears and the manner in which it appears. It studies the 
subjects' perspectives on their world. Also, it attempts to 
describe in detail the content and structure of the 
subjects' consciousness, to grasp the qualitative diversity 
of their experiences, and to explicate their essential 
meanings . 

Sicrnif icance of the Study 
A female's first menstrual flow, menarche, is a major 
health and mental health issue. Several scholars have 
described menarche as a highly significant event in the 
social psychological and physiological development of young 
White girls (Chadwick, 1992; Doswell, Millor, Thompson, & 
Braxter, 1998; Golub, 1992; Grief & Ulman, 1982; Rierdan & 
Koff, 1991; Ruble & Brooks -Gunn, 1982; Simmons, Blyth, & 
McKinney, 1983; Stattin & Magnusson, 1990). Yet, the 
research literature is scarce about the social psychological 
health of African American females during menarcheal onset. 

Nursing is a profession that deals with the bio-psycho- 
socio- spiritual behavior and well-being of all humans of all 
ages across the life span. Meleis (1997) states: 

Nursing as a human science is concerned with the 
experiences of human beings and with health and 
illness matters. Because these experiences are 
shaped by history, significant others, politics, 
social structures, gender, and culture, nurses also 
are concerned with how these perspectives shape 
actions and reactions of human beings. (p. 94) 

The effectiveness of nursing as a discipline is 
dependent upon the knowledge and skills that nurses possess. 
Its effectiveness is also linked to the capacity to 
sensitively and sensibly respond to the health care needs of 
all people including African American females. This study 
will generate new knowledge about the social psychological 
responses of young African American girls to the onset of 
menarche. It also describes parental reactions to their 
child's initial menstrual flow. With knowledge on hand 
about human reactions to this specific event, nurses can 
begin to devise and implement appropriate interventions. 
Thus, nurses and other health professionals can benefit from 
the reports offered by the African American girls and their 
parents about menarche. 

Theory and theory development are significant to the 
field of nursing. Nursing as a discipline has only recently 
begun to develop theories (Meleis, 1997) . Theory allows 
individuals in a discipline to describe, explain, and make 
predictions about interested phenomena. A major aim of this 
research study was to develop a substantive theory that 
could be used to describe emotional responses and social 
psychological practices of young 9/10 year old menstruating 
African American girls and their parents. A substantive 
theory could be a beginning point for building a formal 
theory (Glaser & Strauss, 1967; Strauss & Corbin, 1990). 
This study can be used as a guide to qualitative theory 

development, generate nursing interest toward research and 
theory development, and it can also serve as a backdrop for 
the development of culturally sensitive interventions. 

Definition of Terms 

Significant terms for use in this research study 
include : 

Earlv-maturer is a female child between the ages of 
9/10 who experiences pubertal characteristics, such as 
growth spurt, axillary and pubic hair, breast development, 
and menarche. 

Stressor is environmental for the child relative to an 
absent-biological -father, low- income home, and uneducated 
parents . 

Late-maturer is a female whose pubertal (growth spurt, 
axillary and pubic hairs, breast development, and menarche) 
characteristics become manifested after the age of 12 years, 
with the first menstrual flow occurring after age 13. 

Menarche refers to the female's first menstrual blood 
flow, which can appear between the ages of 9/10. The blood 
flow tends to last 3 to 7 days. Subsequent menstrual flows 
are called menstruation or "period, " indicating the 
completion of a biologically determined hormonal cycle 
(Golub, 1992; Guyton & Hill, 1996). 

Parents are persons serving in the female -gender role 
of mother and the male -gender role of father for six or more 
consecutive months or the individuals with whom the child is 

presently living and receiving guidance and discipline. 
Today's typical American family is no longer of the nuclear 
type or one that consists of biological mother and father 
with their offsprings (Berardo, 1991; Staples & Johnson, 
1993) . Many African American children live in single-parent 
female -headed households, extended families, adoptive 
families, foster-care families, or with fictive kins 
(Billingsley, 1992; Hill, 1998; St. Jean & Feagin, 1998; 
Taylor, Chatters, Tucker, & Lewis, 1990) . Thus, an adult 
who is the young girl's biological birth parent, a fictive 
kin, a foster -care or an adopted parent, a grandparent, or a 
close relative may occupy the role of "mother" or "father". 
Secular trend is a term used to describe the declining 
age of pubertal growth and sexual maturity in boys and girls 
(Tanner 1969, 1978, 1981). 

Origin of the Study 
The origin of this study is linked to a 2 -step 
discovery process. At the first step, within the context of 
a phenomenological experience, my 9 -year -old daughter and I 
discovered that we experienced initial feelings of happiness 
and joy at the onset of her menarche. We celebrated by 
eating out and shopping for her personal supply of menstrual 
products. However, our moment of shared joy abruptly ended 
by the second day of her first menstrual flow. For me, the 
joy ended on the third day of her menarche. 

As a divorced, single parent since her second birthday, 
our mother -daughter closeness strengthened over time. I was 
able to cognitively prepare her for menstruation. Our home 
is a place where "the girls live" and educating her about 
menstruation often times took place as she observed me 
changing sanitary pads. However, I failed to inform her of 
the physical discomforts associated with menstruation, such 
as headaches, abdominal cramps, and pain in the legs and 
lower back. She reacted to the physical discomfort of 
menstruation to the point of tears. She became embarrassed 
and did not want anyone else to know she was menstruating. 
She refused to associate with neighborhood children. She 
envisioned that her playmates could see the print of the 
sanitary napkin and detect the odor emanating from her 
bloody flow; she feared they would learn of her menstrual 
status. She reported that, based on her lived- experience, 
the first menstrual flow was "nasty, smelly, and painful." 
No longer was she smiling about having another physical 
symbol to add to breasts and pubic hairs that showed 
"womanhood, " a similarity that she would share with all 
women . 

I responded. Within a few days, I sought medical 
advice from her private pediatrician about what 
pharmacological agent was available to temporarily halt 
menstruation for 3 or 4 more years until she was older and 
better able to handle the physical discomforts. I was 

assured that no such medical drug existed and that many 
young girls of my daughter's age were experiencing menarche. 
Even this bit of knowledge about the prevalence of menarche 
in younger aged girls did not comfort me. I wanted to know 
if other parents and girls were reacting to menarche as my 
daughter and I had experienced it. 

At the second step, I discovered from a review of the 
research literature, which included Stone's and Barker's 
1939 study that information on the emotional responses of 
African American girls and their parents ranged from sparse 
to nonexistent. Using a final sample of 1,000 American-born 
girls of middle and northern European stock from two large 
junior high schools in Berkeley, California, Stone and 
Barker (1939) wrote: 

All records from Hebrews, Orientals, South 
Europeans, Negroes, and Mexicans were discarded. 
The elimination of these racial stocks appeared to 
be desirable as it is commonly believed that 
American-born children of such racial groups 
differ in age at menarche and in physical traits 
from those of middle and north European stock 
(p. 28) 

In a review of the research literature from 1930 to 
1981, regarding the social psychological responses of 
females to menarche, Grief and Ulman (1982) found non-Whites 
were seldom included in research samples. Most 
investigators, including Stone and Barker, reported that 
African American females started menstruating at a later age 
than Whites and to research the early menarcheal behaviors 


in a racial group of females who menstruated at an older age 
would be nonsensical. These statements were made without 
definitive research data. The prevalent belief was that 
African American girls, and other non- Whites, had an 
inferior nutritional status and a sociocultural lifestyle 
that failed to support the onset of menarche at an early- 
age. White females, on the other hand, were perceived as 
early menstruators, in part, because of their superior 
nutritional status and socioeconomic lifestyle. African 
Americans and other non-Whites failed to meet the middle- 
class White standards needed to be research participants in 
studies dealing with a female's social psychological health 
at menarche. 

The general knowledge base about African Americans in 
psychology has been steadily declining rather than 
increasing. In a content analysis of 14,542 empirical 
articles in 6 major American Psychological Association (APA) 
journals during the 1970-1989 publication period, Graham 
(1992) found a growing exclusion of research about African 
Americans. There was a steady decrease in both number and 
percentage of articles over the years. As Graham stated in 
the title of her article, "Most of the subjects were white 
and middle class" (p. 629) . The dearth of research articles 
on females of color has also been documented by Reid and 
Kelly (1994) , who examined Silver Platter, the CD-ROM 
library database for psychology, for the 1987-1994 

publication period. They found extremely low frequencies of 
research on African American and Hispanic American females. 
Reid and Kelly concluded that the "psychology of women 
implies the psychology of White women" (p. 480) . 

The pattern continues and few present day researchers 
have addressed the social psychological health of non-White 
middle class females at menarche (Amann-Gainotti, 1986; 
Scott, Danette, Panizo, & Roger, 1989; Doswell & 
Vandestienne, 1996) . Albeit some attention is now being 
given to the earlier age at menarcheal onset seen in the 
African American-born female (Herman -Giddens et al . , 1997), 
there remains a need to examine the social psychological 
health of early maturing African American females. 

The impetus for this research study, then, grew out of 
my phenomenological personal experience with a 9 -year -old 
menstruating daughter, and a review of the research 
literature that revealed an embarrassingly limited amount of 
knowledge regarding the social psychological responses of 
young menarcheal African American females and their parents. 

Three major assumptions for this study follow: 

1. Mothers are the major source of knowledge about 
menarche for African American girls ages 9/10 years old. 

2. Menarcheal onset in early maturing girls is an 
important developmental life event that triggers certain 
social psychological responses in the girl and among her 
family members. 

3. Communication is essential between mothers and 
girls ages 9/10 years when confronted with an emotionally- 
laden event, such as menarche. 

Scope of the Study 
The scope of this study is narrow. A total of five 
delimitations and two limitations are described below. 

This study was delimited in five ways. First, only 
9/10 -year-old girls and their parents who identified 
themselves as native-born African Americans were invited to 
participate. Girls with parents born in countries other 
than the United States were not included as participants. 
Racial -ethnic scholars report that the trend for U.S. 
national reports is to label all Black people as African 
Americans (Feagin & Feagin, 1996) . Black individuals 
recently from other countries bring cultural beliefs and 
practices that are generally not similar to native-born 
African Americans (Billingsley, 1992; Feagin & Feagin, 
1996) . 

The focus of this study was the newly menstruating 
9/10 -year-old female and her parents. Young girls older or 
younger than this age group were not invited to participate. 
Data were collected between 2 to 5 days after the 9/10 year 
olds' first menstrual flow. Therefore, this study was not 
opened to 9- and 10 -year -old girls who were 5 days beyond 
the completion of menarche and those who had seen one or 
more flows after menarche. 

This study was delimited to one County located in south 
central Florida. Data collection in extended qualitative 
case studies tend to be costly, time-consuming, and some 
extend over a lengthy time period (Marshall & Rossman, 
1999) . Therefore, the geographical regions for data 
collection included one county. 

All participants in this study were volunteers. 
Participants were also invited to participate based on their 
willingness to participate and provide insightful responses 
in an in-depth interview session. Thus, a purposeful, or 
nonprobability, sample delimits the findings of this study. 
Finally, young girls receiving health care for acute or 
chronic health or mental health problems were not invited as 

Mothers were contacted on a weekly basis to learn if 
their daughters had started to menstruate. Girls were in 
the study 17 days to 13 months before menarche appeared. It 
is probable that this frequent contact encouraged parents, 
and the girls, to focus on knowledge and preparation for 
menarche when they normally might not have done so. 

The openness and richness of the girls' responses to 
interview questions may have been limited by their mothers' 
presence. The original plan for this study was to interview 
the young girl and her mother in separate sessions. 
However, when this type of interview session was presented 

to potential participants during the feasibility study, 
mothers said they would prefer to be present when their 
daughters were interviewed. 

Overview of the Remaining Four Chapters 
Chapter 2 is a description of the theoretical 
perspectives and a review of related literature that 
addresses the major themes and concerns expressed by the 
African American girls and their parents. Chapter 3 
discusses the methods and procedures, which include the 
research design, sampling procedure, participants' 
demographic profiles, data collection, scientific integrity 
and rigor, protection of human subjects, and data analysis. 
In Chapter 4, "living through private time" is discussed as 
the core social psychological theme at menarcheal onset for 
9/10 -year-old African American girls and their parents. 
Interpretations of participants' statements illuminate the 
core theme and its three conceptual domains (symbolic 
bleeding, regulating sexual behavior, and managing menstrual 
flow) . Chapter 5 contains a summary and discussion of the 
findings. Also, included are recommendations for the 
African American family literature, nursing, and future 
research. Suggestions for context -specific interventions 
that could be developed to address health and mental health 
concerns of 9/10 -year-old African American girls at menarche 
are included; this is an anticipated outcome. 


This chapter contains a critical review of the 
literature related to the social psychological responses and 
practices of early-maturing African American females to the 
onset of their first menstrual flow, menarche. The breath 
of this research undertaking is exemplified by the varying 
subjects areas addressed in this review of pertinent 
literature. The review in this chapter is organized into 
sections: (1) age of menarcheal onset, (2) cognition in the 
Child, (3) educational preparation, (4) responses to 
menstruation, and (5) summary. 

Age of Menarcheal Onset 

Current knowledge of the age at menarche in African 
American girls is critical to understanding girls 1 
behavioral responses toward the menstrual event and the 
reactions of their parents (Doswell & Millor, 1993; Herman - 
Giddens et al . , 1997; Phinney, Jensen, Olsen, & Cundick, 
1990). Biophysiological (Guyton & Hill, 1996) and 
sociobiological (Belsky, Steinberg, & Draper, 1991) theories 
offer explanations about "how" or "why" mediating factors 
influence the age at which the first menstrual flow starts. 
The topics covered in this section include chronological age 
at menarche and biophysiological and sociobiological theses. 


Chronological Age at Menarche 

Notable authors (Dalton, 1990; Delaney, Lupton, & Toth, 
1988; Golub, 1992) have written books focusing exclusively 
on menstruation. Their data indicate that the average age 
of menarche for girls in the United States is now 12.8 
years. What many authors fail to mention is that the 
average age of 12.8 years represents the time at menarche, 
since 1952, for White American females (Doswell & Millor, 
1993; Herman -Giddens et al . , 1997; Marshall & Tanner, 1969; 
Phinney, Jensen, Olsen, & Cundick, 1990; Wierson, Long & 
Forehand, 1993) . Apparently, and according to research 
data, the age of menarcheal onset for White American girls 
have remained stable for at least 45 years. Based on the 
limited available data, African American girls, on the other 
hand, have seen a decrease in the age of onset for menarche. 
Earlier data about the onset of menses in African American 
girls are found in MacMahon ' s (1973) analysis of HANES cycle 
II (1963-1965) and cycle III (1966-1970) findings. This 
analysis showed that African American girls began to 
menstruate at 12.52 years of age, which is still younger 
than the 12.8 years seen among White girls. 

The American Academy of Pediatrics (AAP) Pediatric 
Research in Office Settings (PROS) recently conducted a 
national cross -sectional study using 225 clinicians of its 
632 members to establish the current prevalence and mean 
ages of the onset of pubertal characteristics in young girls 

seen in 65 practice settings across the United States 
(Herman -Giddens et al . , 1997). The impetus for this study 
grew out of the reality that no large-scale studies on 
sexual maturation were published on racially diverse groups 
of girls in the United States younger than 12 years of age. 
Importantly, many scholars use the 12.8 years seen among 
White females as a norm for menarche onset in all American 

Results of the 1992/1993 data from the PROS' (Herman - 
Giddens et al . , 1997) study suggest that African American 
girls begin menstruating at a younger age than the currently 
used national norm of 12.8 years. The PROS investigators 
also found many African American females began menarche at 
age 8 years while White females did not start until age 9 
years. Hence, contrary to earlier formulations, African 
American girls obtain physiological maturity more quickly 
than their White counterparts (Herman -Giddens et al . , 1997) 
Other recent reports (Doswell & Millor, 1993; Phinney, 
Jensen, Olsen, & Cundick, 1990) show the mean age of 
menarcheal onset is earlier than 12.8 years. Rees (1993) 
cited the average age of menarche in western, industrial 
societies as 12.8 years, with a normal range of between 10 
and 14 years. Doswell & Millor (1993) examined a cross - 
sectional sample of 75 African American girls ages 9 to 13 
years old at well -child clinics in Harlem, New York. These 
investigators found that 28 percent of their sample were 

menstruating. The reported mean age at menarche was 11.9 
years, which is younger than the 12.16 years of age reported 
by Herman -Giddens et al . (1997) and the 12.8 norm used to 
describe all U.S. girls (Tanner, 1969, 1978, 1981). 

Phinney, Jensen, Olsen, and Cundick (1990) used a 
sample of 581 African American girls and 1,253 non-African 
Americans (Whites and Hispanics) from the data files of 
Cycle III National Survey of Family Growth. The subjects in 
this study were 15- to 44 -year-old females. The most 
commonly reported ages at menarche for African Americans 
were 12 and 13 years and a mean age of 12.60. The mean age 
at menarche for non -African American subjects in this study 
was 12.83 years. These investigators also found that 
menarche occurred between the ages of 8 to 11 years in 150 
of the African American population studied, which 
represented 26 percent of their African American sample. 

Researchers and health -care providers ask, "Why does 
menarche appear at an early age for some girls and a later 
age for others?" Biophysiologists provide a hormonal 
feedback theory that is mediated by genetics, nutrition, and 
health (Guyton & Hill, 1996). Sociobiologists give a 
"simulated" Charles Darwin's survival -of - the- fittest 
evolutionary theory mediated by environmental stressors to 
explain the early age at menarche (Belsky, Steinberg, & 
Draper, 1991; Wierson, Long, Forehand, 1993). The next two 
subtopics presented in this section describe the 

biophysiological and sociobiological theoretical positions 
on the early age of menarche. 
Biophysiological Thesis 

Menarche is an objective indicator that a female's 
menstrual, or sexual, cycle is functional (Golub, 1992) . A 
female's major menstrual and reproductive organs are the 
ovaries, the fallopian tubes, the uterus, and the vagina. 
Guyton and Hill (1996) noted that the menstrual cycle is 
initiated and controlled by a complex hormone -feedback 
system and is comprised of four phases (follicular, 
ovulatory, luteal, and menstrual) . The hormone -feedback 
system involves the central nervous system and is 
hierarchial in nature starting with hormones from the 
hypothalamus, then the anterior lobe of the pituitary gland, 
and finalizing with the ovaries. 

The hypothalamus secrets a gonadotropin- releasing 
hormonal (GnRH) factor. GnRH causes the secretion of the 
luteinizing hormone (LH) and follicle- stimulating hormone 
(FSH) from the anterior lobe of the pituitary gland. FSH 
stimulates the complete development of a single Graafian 
follicle in the ovary for the follicular phase of the 
menstrual cycle. This phase extends over the first 14 days 
of the cycle. The ovulatory phase is triggered by LH and is 
identified by the release of the ovum from the Graafian 
follicle which travels down the fallopian tube to the 
uterus. During the luteal phase, the corpus luteum develops 

in the ovary and secretes progesterone and estrogen 
Progesterone helps to further prepare the uterus ' 
endometrium to receive a fertilized egg. In the absence of 
fertilization of the ovum for pregnancy, the corpus luteum 
regresses, estrogen and progesterone levels decline, and the 
uterus' endometrium begins to slough away, and menstruation 
begins. From these characteristics, a phase in the 
menstrual cycle, is identified by the condition of the 
follicles and ovum. Once the hypothalamus detects low 
levels of estrogen in the blood, FSH production from the 
anterior lobe of the pituitary gland increases and the 
menstrual cycle begins once again. 

Guyton and Hill (1996) cited genetics, nutrition, and 
health as mediating factors influencing the age of menarche 
for developing young girls. Studies of identical twin 
sisters growing up together indicated that they reached 
menarche about two months apart and fraternal twins differed 
by about 12 months. Mother -daughter and sister-sister 
correlations were reported by Chern, Gatewood, and Anderson 
(1980) . Tanner (1978) noted from a genetic view that a 
late-maturing girl is as likely to have a late-maturing 
father as a late-maturing mother. Fathers, then, can also 
exert an equal influence on a girl's growth rate and 
menstrual maturation. 

Malnutrition retards growth and delays menarche. Young 
females who are undernourished do not menstruate as early as 

those who are not undernourished (Guyton & Hill, 1996) . The 
drop in age at menarche from 1830 and 1960 for White 
American females coincided with the increased availability 
of protein in the diet. In those countries where nutrition 
remained inadequate during this period, age of menarche is 
high. For example, in contrast to the average age of 
menarche in the United States, which is cited as 12.8 years 
(Tanner, 1978), in Bangladesh it is just under 16 years, and 
among certain New Guinea tribes, it is about 18 years 
(Menkin, Watkins, & Trussel, 1980) . 

A young girl's health can impact her menstrual ability 
(Golub, 1992; Guyton & Hill, 1996). Menstruation will not 
occur in girls with Turner's Syndrome since they are without 
ovaries. Menarche can be delayed if a young girl has 
ulcerative colitis, regional enteritis, cystic fibrosis, 
congenital heart disease, uremia, diabetes mellitus and 
other health conditions. Some health conditions can cause 
menarche to occur at a later age. These conditions include 
hypothyroidism, central nervous system tumors, encephalitis, 
and head trauma. Girls who are inactive, mentally retarded, 
or bedridden tend to experience menarche at an earlier age 
than their counterparts (Golub, 1992) . 
Sociobioloaical Thesis 

Belsky, Steinberg, and Draper (1991) posed the 
sociobiological theory from their study of middle-class 
White postmenarcheal females. This theory espouses that 
children raised in biological -father-absent households do 

not develop expectations for enduring heterosexual pair 
bonds and marital stability as prerequisites for 
childbearing and childrearing. Rather, these children as 
adolescents and young adults engage in early- for -age and 
opportunitistic sexual intercourse. This chain of events, 
according to Belsky et al . (1991), conditional upon low or 
nonexistent paternal involvement during early childhood, is 
not proposed as a conscious process. Instead, it is a 
sociobiological phenomenon, an unconsciously motivated 
reproductive strategy adaptive to the environment. 
Nevertheless, according to Belsky et al . , early menarcheal 
onset is a human survival and adaptive response when there 
is a scarcity of available males to copulate with females 
for reproductive purposes. 

Using data from a longitudinal New Zealand study of 16- 
year-old White upper-class girls, Moffitt, Caspi, Belsky, 
and Silva (1992) noted that family conflict and father 
absence in childhood predicted an earlier age of menarche. 
A self -report of menarche was taken within 1 to 5 years of 
the girls' menarche. There was a mean age of 13 years at 
menarche for their sample of 402 girls. Family conflict was 
assessed by having the mother and the girl complete the 
nine-item Moos Family Relations conflict scale. This scale 
measured the degree to which the family was characterized by 
conflictual interactions and included items related to 
yelling and hitting each others. Presence of the biological 

father in the home environment was determined by a self- 
report from the mother and the young girl; fathers were 
absent prior to age 11 years for the child. 

Moffitt et al. (1992) found no significant correlation 
between limited family financial resources and early age at 
menarche, r(372) = .07. There was a significant correlation 
between family conflict at age 7 and menarcheal onset, 
r(379) = -.13, p < .01. Also, a significant correlation was 
associated with a greater number of years of father absence, 
r(143) = -.12, p < .01. However, they found that the best 
predictor of menarche was the young girl's weight, r(345) = 
- .28, p < .001. 

Wierson, Long, and Forehand (1993) used a sample of 71 
middle- class White adolescent girls and their mothers to 
examine two family stressors, divorce and interparental 
conflict, in light of Belsky et al . ' s (1991) sociobiological 
theory on age at menarche. Forty four girls resided with 
both their biological parents in a nuclear family situation, 
and 27 lived with their mothers in divorced families. The 
age range for this sample of girls was 11 to 18 years. 
Interparental conflict was assessed using the 10 -item 
O'Leary- Porter Scale. This scale included items relative to 
arguments over disciplinary actions in the child's presence. 
The researchers found that the onset of menarche for girls 
from divorced families was six months earlier than for girls 
from families in which parents were married. 

In summary, empirical data show that when African 
American females are used as sample members in studies 
dealing with age at menarche, investigators report that the 
commonly used 12.8 median age at menarche in the United 
States as a norm for all females is not consistent with 
their findings for African American females. Data from 
recent research findings suggests early menarche has 
resulted in an ever- increasing proportion of African 
American females attaining reproductive capacity at younger 
ages. Hence researchers suggest the physical capacity for 
sexual and reproductive activity is earlier in African 
American females than in White and Hispanic females 
(Doswell, Millor, Thompson, & Braxter, 1998; Herman -Giddens, 
1997; Phinney, Jensen, Olsen, & Cundick, 1990) . 

Cognition in the Child 
Piaget and Inhelder (1996) maintained that children 
between the ages of 7 and 11 years are in the concrete 
operational period of intellectual development and are 
unable to think and reason about abstract concepts. 
Similarly, Klahr (1982) argued that children are limited in 
the amount of information they can remember; the presence of 
concrete objects makes problem- solving easier simply because 
the objects serve as aids to memory. The specific deficit, 
according to Klahr, rests with memory, not with a 
qualitatively distinct way of viewing the world. 

Information Processing 

In the 1960s when Piaget ' s theory of cognition became 
popular, American psychologists begun to view thinking as a 
kind of information processing activity (Chi & Koeske, 
19 83) . This view held that an important part of cognition 
is the taking in of information and processing it into a 
meaningful and useful form, much like the function of a 
computer. By making comparisons and adjustments, drawing on 
information already stored in memory, the individual learns 
about problem- solving and decision-making (Siegler, 1996) . 
Klahr (1982) , a leading figure in the information-processing 
approach to human thinking, expressed his dissatisfaction 
with Piagetian theory about development by stating: 

For 4 years now we have had assimilation and 
accommodation, the mysterious and shadowy forces 
of equilibration, the "Batman and Robin" of the 
developmental processes. What are they? How do 
they operate? Why is it after all this time, we 
know no more about them than when they first 
sprang upon the scene? What we need is a way to 
get beyond vague verbal statements of the nature 
of the developmental process (p. 80) . 

Most psychologists who adopt the information -processing 
thesis, focus on the ways in which psychological processes 
are modified as the result of patterns of input from the 
environment (Case, 1992; Massaro & Cowan, 1993). Following 
the environmental -learning path, many believe that cognition 
is a continuous process in which limitations on cognitive 
capacity are gradually overcome, long-term memory capacity 

gradually increases, behaviors are routinized, and 
strategies are developed to link input more effectively to 
output (Klahr & Wallace, 1976; Siegler, 1996) . 
Storage and Use of Information 

The amount of information that young children take in 
and their ability to store and manipulate it is limited. 
Chi and Klahr (1975) found that 5-year-olds could perceive 
no more than three objects flashed simultaneously on a 
screen, whereas older adolescents and adults could take in 
six or seven objects at a glance. Thus, older children and 
adults can work through various steps in complex problems 
without losing track of what they are doing, but young 
children cannot (Kail, 1990) . 

Also, older children and adults have generally 
accumulated more knowledge than young children, process 
information more rapidly, and have more effective strategies 
for dealing with problems (Chi & Koeske, 1983; Siegler, 
1996). Siegler (1996) and Flavell, Miller, and Miller 
(1993) posit that performance improves in the course of 
development because of maturation of the brain (Case, 1992; 
Fischer & Rose, 1995) and the development of more effective 
information -processing routines (Vurpillot, 1968; Zinchenko, 
Chzhi-Tsin, & Tarakanov 1963). As a consequence, older 
children have more information available in long-term memory 
storage that can be swiftly applied to new problems as they 
arise. Case, Marini, McKeough, Dennis, and Goldberg (1986) 

noted that young children take longer to repeat a number 
such as 10 or 2 than older children. They also reported 
that older children named individual numbers quickly, which 
reduced the time interval between numbers and increased the 
likelihood of retaining the numbers in memory. 

The ability of older children to repeat digits more 
quickly appears to be just one instance of a more general 
tendency for older children and adults to carry out 
cognitive operations faster than younger aged children. In 
comparison with young adults, 4- to 5 -year olds generally 
responded 300 percent more slowly, 8-year-olds responded 200 
percent more slowly, and 11 -year-olds took 50 percent more 
time to respond to visual cues. As a consequence of this 
increase in mental processing speed, older children and 
adults can be expected to execute more cognitive operations 
in a given time span than younger children. Therefore, they 
tend to demonstrate increased intellectual effectiveness 
(Kail and Park, 1994) . 

Educational Preparation 
Early maturing girls need a Knowledge base about 
menarche prior to its onset. At the early signs of 
impending menarche, young girls can benefit from a mental 
store of knowledge upon which to govern their behavioral 
responses relative to the menstrual event. On the other 
hand, menarche can be a traumatic experience for young girls 
who have received little or no information about 
menstruation (Amann-Gainotti, 1986) . 

Limited Educational Preparation 

Informational sources about the menarche usually 
consist of mother, peer- friend, and other relatives. 
Education preparation about menstruation in the public 
schools, however, generally does not include young girls in 
the third grade or their parents (Swenson, Foster, & Asay, 
1995) . Many African American females start menstruating 
while in the third grade, or by 9/10 years of age (Herman- 
Giddens et al . , 1997), but information from school health 
nurses is minimum to nonexistent for this grade level. 
Consequently, these young females may not receive any 
education about their impending menarche. 

Swenson, Foster, and Asay (1995) found that few 
classroom teachers and nurses employed by the public schools 
and health departments include educational material about 
menstruation at grade four. Also, no school nurse from a 
sample of N=39 offered information to students in the third 
grade about the developmental event, menarche. Grade five 
(82%) was the most frequently reported grade by nurses for 
teaching menstrual content. The nurses reported that they 
were the persons (85%) who. most often taught information in 
the schools about menstruation. The content that nurses 
provided students in the public schools were related to 
menstruation, reproduction, and sexuality. 

Important sources of information for pre- and 
postmenarcheal girls are mothers and friends, and to a 

lesser extent other relatives and teachers. Amann-Gainotti 
(1986) also found this to be a concern in Italy. On the 
whole, the study of 176 randomly selected Italian females, 
ages 11 to 14 years, showed fathers were minimally involved 
for 2% of the 91 premenarcheal girls and not at all involved 
in providing information to 85 postmenarcheal girls. Also, 
Amann-Gainotti found that this sample of working-class 
families reported that few books or magazines (4% for pre- 
and 8% for postmenarcheal girls) on menstruation were used 
to obtain information, which could had been partly related 
to the subjects' middle to low socioeconomic lifestyle. 
Mothers as Teachers about the Menarche 

In a study conducted by a nurse, (Dashiff , 1992) , 
mothers were the primary source of information about 
menarche for 23 African American girls who had not started 
menstruating. Data were collected through individual 
audiotape interviews using open-ended questions with a 
sample of 38 fifth-grade African American girls ages 10 to 
14 years. This sample of young girls came from three middle 
schools in the same district. Friends, older sisters, and 
teachers were also mentioned as sources about menstruation. 
Girls who learned first from their mothers in private talks 
or who received directions from their mothers about the use 
of menstrual products and hygiene measures rated the 
educational experience as pleasant. 


Girls who felt the most educationally prepared, 
reported positive feelings about starting menstruation 
(Brooks-Gunn & Ruble, 1980; Clark & Ruble, 1978; Hill, 
Holmbeck, Marlow, Green, & Lynch, 1985; Kieren, 1992; 
McGrory, 1990; Scott, Danette, Panizo, & Roger, 1989) . 
Scott et al. (1989) reported in their study comparing 67 
postmenarcheal African American Girl Scout girls to Brooks- 
Gunn & Ruble's (19 80) sample of White Girl Scouts that the 
less prepared the girls perceived themselves to be, the more 
negative feelings they expressed about menarche. Also, they 
found a tendency existed for the girls who felt more 
prepared to express more positive feelings. Another issue 
Scott et al . (1989) addressed was the relationship between 
the girls' age at menarche and their feelings of 
preparedness. Scott et al. (1989) found that those girls 
who experienced menarche early, age younger than 12 years, 
felt less prepared than those whose menarche occurred later, 
after age 12. 

Koff and Rierdan (1995) asked 157 White, middle- to 
upper-middle-class 9th-grade girls in a longitudinal study 
how they would prepare younger girls for the menarcheal 
event, and how they would advise parents to prepare their 
daughters. The girls emphasized the need for emotional 
support and assurance that menstruation was normal and 
healthy. They discussed the practical aspects of menstrual 
hygiene and the subjective experience of how one actually 

feels; they felt that these feelings should not be kept a 
secret from a young girl expecting menarche to arrive soon. 
Ninety per cent of the girls talked about menstruation with 
their mothers, but few had discussed it with their fathers 
and other male sources. Fathers were expected to be 
supportive, but silent. A few girls believed fathers should 
be excluded completely. Responses from this sample of girls 
suggested early preparation should include a shift in focus 
from the biology of menstruation to the more personal, 
subjective, and immediate aspects of the experience. The 
young girls also supported a conceptualization of menstrual 
education as a long-term, continuous process, beginning well 
before menarche and continuing long after its onset. This 
sample of girls also suggested that mothers should keep the 
fact that they have started to menstruate a secret. 

Responses to Menstruation 
The age of young girls at menarche is relevant and can 
influence their social psychological behavior, and how 
others respond to them. Menarche brings a host of changes 
influencing the young girl's physiological, psychological, 
social, and familial status. As a physiologic event, 
menarche has irrevocable implications for the young girl's 
female gender (Lee, 1994) . Through menarche, she is 
transformed into a sexual being capable of becoming pregnant 
(Lee & Sasser-Coen, 1996) . The physical changes (increase 
in height and weight; redistribution of body fat; bodily 

proportions transformation; emergence of secondary sex 
characteristics and menarche) associated with puberty- 
trigger a chain reaction of psychological changes concerning 
how the young girl perceives herself (Richards, Boxer, 
Petersen, & Albrecht, 1990; Slap, Khalid, Paikoff, Brooks- 
Gunn, & Warren, 1994) and how others perceive her (Delaney, 
Lupton, & Toth, 1988) . The responses to menarche, a normal 
developmental event, are presented in this section under 
three domains: psychological responses, relationships with 
peers, and familial status and relationship. 
Psychological Responses 

Several theories have been used by investigators over 
the years to present psychological responses of females to 
the menstrual process. The dominant theory discerned by 
Grief and Ulman's (19 82) review showed that previous 
researchers relied on Freud's psychoanalytical thoughts 
about penis -envy and castration to describe females' 
behavior at menstruation. Few investigators used Benedict's 
(1954) and Mead's (1952) thoughts about the meaning of the 
menarcheal event in a particular culture. Grief and Ulman 
reported that Stone and Barker (1939) used the 
biopsychosocial model about menarche to stress the superior 
lifestyle and racial -ethnic qualities of White American 
females over other groups of females. From the 1930s to the 
1980s, according to Grief and Ulman's review, the 
psychological health of non-White females was virtually not 
considered from a theoretical position. 

By the mid-1980s and the start of the 1990s, a few 
investigators (Dashiff, 1992; Doswell & Millor, 1993; 
Doswell & Vandestienne, 1996; Du Toit, 1987; Phinney, 
Jensen, Olsen, & Cundick, 1990; Scott, Danette, Panizo, & 
Roger, 19 89; Skandhan, Pandya, Shandhan, & Mehta, 19 88) 
conducted research studies on menarche with non -White 
females. Research scholars sought the feminist perspective 
(Lee, 1994), the childhood ecological model (Baumrind, 1993; 
Bronfenbrenner, 1997), and the sociobiological model 
(Belsky, Steinberg, & Draper, 1991; Moffitt, Caspi, Belsky, 
& Silva, 1992; Wierson, Long, & Forehand, 1993) as 
theoretical positions on which to present empirical data 
about menarche. 
Negative responses 

A review of the literature done by Grief and Ulman 
(1982) from the 1930s to 1981 showed that investigators 
reported middle-class White American female responded to 
their menarcheal onset with shame, embarrassment, fear, 
disgust, nervousness, humiliation, and increased self- 
consciousness. Many White females reported menarche was a 
nuisance and physically uncomfortable; this lead to a 
limitation on many routine childhood play activities and 
peer interaction. Grief and Ulman learned from their review 
that the parent-child relationship suffered. The mother- 
daughter relationship suffered the most with increased 
arguments and distance. These authors wrote that some of 

the researchers concluded that White females treated 
menarcheal onset as a hygienic crisis rather than a 
maturational milestone. For many White females, then, 
Menarche was viewed as a negative and traumatic experience 
that served to lower their self-esteem. 

Amann-Gainotti (1986) observed that girls' knowledge 
deficit and negative beliefs about menstruation were 
reflected in their responses to the question, "Can you tell 
me what menstruation is" (p. 705)? For premenarcheal 
girls, 42% stated that "menstruation is monthly bleeding" 
and 9% gave no response. Few young girls in Amann- 
Gainotti' s sample had any understanding about the physiology 
of menstruation. Here is an example. A 13 . 2 -year-old 
postmenarcheal girl stated: 

Menstruation is a flow of blood, but I don't know 
whether it is an arterial or a venous one. 
However, in my opinion, it starts from the heart, 
goes around the whole body, and comes directly 
into the stomach. When it arrives in the stomach, 
the blood knocks violently against the ovaries and 
they break, and that's why we lose blood from the 
vagina (p. 706) . 

Amann-Gainotti also noted that girls without educational 
preparation voiced menarche as a traumatic experience, which 
was further exemplified through such remarks as, "I didn't 
know what was happening. I thought I had to die" (p. 709). 
"I got terribly afraid. I didn't know what to do" (p. 709). 
McGrory (1990) noted that embarrassment was most often 
the response to the 6 -factor Menstrual Attitude 

Questionnaire (MAQ) by premenarcheal girls with a mean age 
of 13.34 years. Seventy participants in a sample of 95 
middle- class White girls from biological -mother- father homes 
provided incomplete, or partial, responses for data on the 
MAQ. Further, McGrory (1990) noted that 67 of 162 parents 
refused to consent to their daughters' participation in the 
study. McGrory wrote that parents thought it was "a much 
too personal topic" (p. 268) . McGrory surmised that the 
refusals suggested the sensitive and embarrassing nature of 
menstruation as a topic of discussion for many young girls 
and their parents. 

Topics used by Lee (1994) from a feminist perspective 
to describe the menarcheal experience of females with an age 
span of 18 to 80 years included contaminating bodies, 
alienated bodies, anxious bodies, and bodies and boys. 
According to Lee, these titles represent the negative 
position females find themselves at the onset of their 
menstrual flow in a patriarchal society that devalues women. 
A White working-class woman in her thirties responded to 
contaminating bodies by stating: 

When I first started menstruating (the very first 
time) I had experienced incredible stomach pains 
the night before. I stayed in bed all night and 
was the first one up in the morning. I went to 
the bathroom and lo and behold there was blood I 
felt mortified because I knew what had happened 
I felt incredibly ashamed and didn't tell anyone 
for a year (I used tissue paper) . Now I was like 
my mother, a woman who had a bad smelly part of 
her. This, for the most part, is also how men see 
menstruation, as something filthy belonging to a 
woman that makes them mentally unstable (p 347) 

For Lee's sample, menarche was something that invaded their 
"self," something that happened to them, and the disdain 
affiliated with the blood encouraged many women to go to 
lengths to hide the evidence of their contamination. Many 
of the women reported fears during childhood of showing 
proof of wearing pads or staining cloth garnments or bed 
sheets. They learned early that they must hide all evidence 
of menstruation from boys and men, brothers and fathers. 
This, according to Lee (1994) contributed to a self- 
consciousness for girls who were used to playing with boys. 
One young lady stated, "When I didn't have my period I 
didn't mind playing with the guys, but when I did, I was 
afraid someone would see me, like something might leak 
through" (p. 353) . 

Results from several studies (Brooks-Gunn & Ruble, 
1980; Clark & Ruble, 1978; Hill, Holmbeck, Marlow, Green, & 
Lynch, 1985; Koff & Rierdan, 1995; McGrory, 1990) using 
middle- class White samples and various measures showed 
postmenarcheal girls have more negative attitudes towards 
menstruation than premenarcheal girls, and that they 
experience more negative emotions than those girls who have 
not yet experienced menarcheal onset. These differences 
occurred despite educational preparation. 

Results from an all African American Girl Scout sample 
of 67 postmenarcheal girls with a mean age of 13.5 showed 
negative feelings about starting their menstrual flow 

(Scott, Danette, Panizo, & Roger, 1989) . Ten percent of the 
girls identified fear, discomfort, and pain as responses on 
the Ruble and Brooks -Gunn (19 82) questionnaire that was used 
with White Girl Scouts from similar biological mother- father 
homes and socioeconomic class strata. Twenty- four percent 
of Scott et al.'s (1989) sample reported that menarche meant 
"nothing" (p. 365) . 

A cohort longitudinal study done by Caspi and Mofitt 
(1991) with an all White middle-class sample of 1,037 girls 
tested the early- timing hypotheses of early-maturing girls' 
adjustment difficulties in adolescence. The researchers 
noted that early maturing girls exhibited adjustment 
problems at age 13 years. Additionally, the early onset of 
menarche magnified behavioral problems from earlier 
Positive responses 

Grief and Ulman (1982) showed in their literature 
review that a few investigators reported positive menarcheal 
responses by the White female, which consisted of being 
surprised, but happy and proud about the womanly 
similarities to their mothers. Proximity of mothers and 
daughters grew closer and openness in communication was 
enhanced. Young White females, according to Grief and 
Ulman 's review, with positive experiences to menarche were 
previewed about its onset and what to expect. 

Amann-Gainotti (1986) noted that forty-one percent of 
the postmenarcheal girls reported positive feelings about 
their first menstrual flow in that it made them feel more 
mature, more adult, and similar to their friends. However, 
47% made a negative judgment, and 12% were ambivalent. The 
negative responses were related to feelings of annoyance 
with the physical discomfort and pain, limitations of 
liberty from parents, and feelings of shame in front of boys 
and male family members. 

Amann-Gainotti (1986) also reported a significant 
relationship between girls' positive responses to their 
initial menstrual flow and the family's attitudes toward 
menstruation ( X 2 = 32.34, p < .001). Also, there was a 
significant relationship between positive responses and 
menarcheal education (^2 = 13.04, p < .001). 

In a longitudinal study of growth carried out by Jones 
and Mussen (1958) with a sample of 34 White middle-class 
subjects, 16 girls were labelled early-maturers and 18 were 
labelled late-maturers from measurements of their wrists and 
hands. In response to menarche, early-maturers indicated a 
greater need for recognition. The 18 item Thematic 
Apperception Test (TAT) was administered individually to the 
girls during their last year in high school. Results from 
the TAT permitted Jones and Mussen (1958) to conclude that 
because early-maturing girls were out-of -phase with their 
peers, they had a tendency to have greater difficulty in 

personal -social relations at first. Eventually, early- 
maturers' personal -social relations improved in later 
adolescent years which put them in step with their peers. 
Self -Concept 

A young girl's self -concept is comprised of her self- 
esteem and self-image (Erikson, 1963; Harter, 1990). Early 
menarche may make African American girls vulnerable to low 
self-esteem and self-image (Scott, Danette, Panizo, & Roger, 
19 89) . The manner in which an early maturer views her 
personal transition and physical body image at menarche may 
give rise to her integration of a revised self-image. Fears 
of being different or out of developmental synchrony with 
same -age peers in this physical aspect may shape the 
unfolding of negative body images and a devalued self -hood 
(Bios, 1962; Rierdan, Koff , & Stubbs, 1987) . 

The onset of puberty and menarche may precipitate 
changes in self-esteem and self-image, making girls 
vulnerable for high-risk behaviors (Caspi & Moffitt, 1991) . 
This has particularly significant ramifications for many 
African American girls because of their documented early age 
of puberty and menarche. It has traditionally been asserted 
that African -American children and adolescents are more 
likely to have low self-esteem because of their membership 
in a stigmatized racial group, although many researches who 
make this assertion rely on the racial preference findings 
rather than measured self-esteem (Cross, 1991; Spencer & 

Marks trom- Adams, 1990; Tuck, 1997). Contrary to the 
stigmatization viewpoint, other recent research suggests 
that African -American children have self-esteem equal to or 
higher than that of their White counterparts (Simmons, 
Brown, Bush, & Blyth, 1978; Tashakkori & Thompson, 1991). 

Tashakkori (1993) found that when compared with White 
students, African- American middle school students held more 
positive self -beliefs regarding physical appearance and 
attractiveness, and reading ability. They, however, have 
more negative self -beliefs regarding self -efficacy and 
situational control. Regarding gender, the dramatic changes 
in physical appearance that indicate pubertal maturation may 
have a greater effect on self-esteem in girls because 
attractiveness and satisfaction with appearance are more 
strongly associated with positive self -appraisal and well- 
being in girls than boys (Fox, Page, Armstrong, & Kirby, 
1994). Hence, girls may be at greater risk for poor self- 
esteem, particularly if their pubertal growth and 
development pattern are perceived as out of synchrony with 
same-age peers (Amann-Gainotti, 1986; Rierdan & Koff, 1985). 
Research literature supports the idea that self-esteem 
is fragile, changing, and on the low end during the pubertal 
period (Simmons, Rosenberg, & Rosenberg, 19 73) . Further 
research by Simmons, Blyth, VanCleave, and Bush (1979) 
showed that early-maturing girls were more likely to have 
lower self-esteem compared with on -time maturers. Other 

studies observed changes in self-esteem as a function of 
time rather than pubertal onset. One such study measured 
self-esteem in three racially diverse adolescent age groups: 
pre- (8 to 11 years), early (12 to 14 years), and late (> 15 
years) adolescence (Simmons, Rosenberg, & Rosenberg, 1973) . 
The investigators reported that the preadolescent group 
demonstrated positive self-esteem. However, 12 -year-old 
subjects showed significantly lower self-esteem scores, 
suggesting perhaps that as children enter early puberty and 
adolescence, self-esteem declines. 

Body- image in children during puberty across cultural 
groups have been less frequently documented. Data from a 
larger study examining cardiovascular health in African- 
American children suggest racial differences in satisfaction 
with body image. Brown, Schreiber, McMahon, Crawford, and 
Ghee (1995) found that prepubertal (9/10-year-old) African- 
American girls had higher body- image scores and greater 
tolerance for higher body mass index than prepubertal White 

Personality Characteristi cs of Maturing FfimalPg 

A number of researchers have examined differences in 
personality characteristics or behaviors of pre-and post 
menarcheal girls to determine the impact of menarche on 
personality functioning (Grief & Ulman, 1982). stone and 
Barker (1939) used a sample of 1,000 White American-born 
girls of middle and north European stock to compare pre- and 

postmenarcheal girls. Questionnaires were administered to 
7th , 8th, and 9th grade girls. It was noted that the 
postmenarcheal girls gave mature responses more frequently 
than the premenarcheal girls as determined by Pressey and 
the Sullivan tests. The groups differed in items measuring 
their responses to personal appearance, heterosexual 
interests and attitudes, avoidance of physical exertion, 
daydreaming, and home conflicts. Because same -aged girls 
differed on the personality and interest measure, Stone and 
Barker (1939) concluded that the girls' personality changes 
were associated with physiological maturity and were related 
to their changes in attitudes and interests. As expressed 
by Stone and Barker, "the results of this study are not to 
be generalized to other racial groups, because of 
differences in biological makeup and in cultural practices" 
(p. 28) . 

Rierdan and Koff (1980) investigated the impact of 
menarche on body image and psychological functioning. The 
authors administered the Draw- a -Person test and a 
questionnaire regarding developmental changes to a sample of 
94 seventh and eighth grade girls. The drawings were 
analyzed and scored according to Haworth and Normington's 
four- level Sexual Differentiation Scale, and the Saarni and 
Azara's criteria for aggression-hostility and insecurity- 
lability. Results showed no difference in the girl's 
anxiety before and after menarche. 

Familial Status 

The onset of puberty and menarche can cause dramatic 
and turbulent changes within the family structure. Some 
researchers suggested that menarche triggers a re -definition 
in family relationships that influences both the emotional 
communications and behavioral patterns of the family 
(Holmbeck & Hill, 1991; Rich, 1990). One reason why the 
onset of puberty and menarche cause such turmoil is because 
developmental changes are the matrix from which the ultimate 
separation- individuation from the family emerges 
(Bronfenbrenner, 1997) . 

Menarche brings with it a host of implications that 
have a serious impact on the family. Parents must now 
recognize their daughter's burgeoning sexuality. With 
menstruation comes the possibility that the girl will act in 
a sexual manner. Thus, for the first time, then, the young 
girl is vulnerable to AIDS, sexually transmitted diseases, 
and pregnancy (DuRant & Seymour, 1990; Doswell, Millor, 
Thompson, & Braxter, 199 8) . 

Holmbeck and Hill (1991) investigated the influence of 
the young girl's menarcheal status on the emotional 
relationships within the family. These researchers found 
that interactions imbued with conflict and assertiveness 
between the child and her parents are most pronounced at 
menarche, especially between the child and her mother. 
Mothers and daughters became increasingly argumentative 

about limitations and restrictions placed on the newly- 
menstruating young girls. These findings were similar to 
the data from a study carried out by Papini and Sebby 
(1987) , which found that relations between mother and the 
young girl deteriorated as the mother perceived that she 
lost control over the early maturer. 
Menarche to Sex and Pregnancy 

Children are sexual beings (Goldman & Goldman, 1988) 
and sexual curiosity rise markedly with the onset of 
menarche (Rutler, 1997) . Early menarche may contribute to 
the early initiation of sexual behaviors, putting the early 
maturer at risk for pregnancy and sexually transmitted 
diseases. Around menarcheal, then, girls are likely to 
become much more sexually active, both because of the 
symbolic significance of secondary sexual characteristics 
(breast development etc.), and a hormonally driven interest 
in fuller sexual relationships. 

Menarche is a symbolically significant time in many 
societies when girls are ritual ly separated from the company 
of boys (Delaney, Lupton, & Toth, 1988) . But in modern 
societies such segregation rarely takes place, and sexual 
relationships between young adolescents (within the context 
of a private peer culture, quite separate from the world of 
adult control) are common (Bios, 1962) . 

Vinovskis (1988) reported data from the 1983 National 
Longitudinal Survey of Youth (NLSY) that showed 59.4% of 

African American female adolescents were sexually active 
prior to marriage by age 18 years compared with 41.6% of 
White females. The data also showed that unmarried young 
African American females from poorer socioeconomic 
backgrounds with uneducated mothers were more likely to be 
sexually active than those from middle- or upper-class 
homes . 

DuRant and Seymour (1990) studied sexual behaviors in 
Hispanic females in the United States. A range in onset of 
menarche of 9 . 1 years to 14.2 years was recorded. The 
earlier the age at sexual maturity, the more likely it was 
that a young girl would engage in regular intercourse by age 
14. At that age, 80% of urban girls with onset of menarche 
before age 12 had engaged in sexual intercourse. Somewhat 
similar findings came from Leite, Everardo, Buoncompagno, 
Leite, Battistori (1994) who surveyed college Brazilian 
middle- class females. This survey showed that 28% of the 
females had achieved sexual intercourse by age 16. Further, 
they reported that 9% Nine per cent had experienced menarche 
at age 10 or younger, and 58% by age 12. Research reports 
suggest that earlier menarche is linked to a young age at 
commencement of sexual intercourse. 

Children in all cultures take pleasure in fondling and 
masturbating themselves from an early age (Kinsey, Pomeroy, 
Martin, & Gebhard, 1953; Langfeldt, 1981). These activities 
do not decline in what Freud termed the 'latency' period 

(ages 7 to 11) but continue with increasing frequency 
throughout childhood. It is atypical for children to engage 
in oral exploration of a friend's genitals (Friedrich, 
Gramsch, Broughton, Kuiper, & Beilker, 1991) . But, about 
10% of children attempt or achieve some form of heterosexual 
coitus by the age of 12 (Masters, Johnson, & Kolodney, 
1992) , while a smaller number engage in repeated sexual 
contacts with a child of the same sex. 

Prendergast (1993) reported that it is quite common in 
America for White children 10 and 11 -year-olds to begin 
dating and to become sexually experienced with intercourse. 
A comparison of surveys of American teenagers from 19 81 to 
1990 indicates that rates of sexual activity in early 
adolescence, including the frequencies of intercourse, and 
the number of different partners involved, have increased 
slightly with about seven per cent of children now having 
had their first experience of completed sexual intercourse 
by age 13 (Miller, Christopherson, & King, 1993) . 

In Barone's (1995) American survey of 119 inner-city 
6th and 7th graders (average 12.4 years) 19% of girls had 
engaged in high-risk sex, which was defined as intercourse 
without the use of condoms. In another American study, 
Farrell, Danish, and Howard (1992) reported sexual 
intercourse rates of 35% in girls by age 14. In a survey 
done by Orr, Breiter, and Ingersol (1991) with 1,750 
students attending schools in stable, working class urban 

areas in America, 37% of 13 -year-old girls had achieved 
intercourse at least once, with 4% having intercourse at 
least weekly. 

American research (Elliott & Morse, 1989; Farrell, 
Danish, & Howard, 1992; Barone, 1995) suggests that deviant 
behaviors and poor school work precede sexual activities 
with peers up to age 13. In other words, precocious sexual 
activity can be part of a general sub-culture of rejecting 
mainstream values, and seems to form part of a drop-out, 
hedonistic counter-culture. It should be noted, however, 
that the Calgary study completed by Meikle, Peitchinis, and 
Pearce (1984) did not confirm this finding. Promiscuous 13- 
year-olds in that study did not come from disadvantaged 
backgrounds . 
Peer Relationships 

The average age of 12.16 years at menarche for the 
African-American female is a developmental epoch during 
which peer relations begin to assume prominence over the 
young girl's status in the family (Koff, Rierdan, & 
Jacobson, 1981) . This is a time when many girls have best 
friends and begin to assimilate into a regular group of 
peers. Many put a high value on the opinions of their 
friends, and it is argued that those who value their 
friends' opinions more than their parents' are more sexually 
active (Newcomer, Udry, & Cameron, 1983) . As such, it is 
appropriate to ask whether the menarche influences peer 

relationships. In addition, since the menarche is 
associated with changes in the girl's physical appearance 
and body- image perception, it is worth-while asking how the 
event enables the girl to further assimilate with peers. 

A major dilemma for the postmenarcheal girl concerns 
whether or not to tell one's best friend about the onset of 
menstruation. Investigators' survey showed more pre- as 
opposed to postmenarcheal girls expected to tell their close 
friends about the beginning of their period (Koff, Rierdan & 
Jacobson, 1981) . The responses of many of the girls in the 
survey revealed heightened self -consciousness close to 
anguish. These girls seemed obsessed about whether or not 
others at school knew of their changed status. One of the 
girls in the survey wondered if everyone would still like 
her when her secret was discovered. These findings are 
consistent with earlier patterns reported by Whisnant and 
Zegans (1975) in which premenarcheal girls seemed more 
excited and enthusiastic about the prospect of menstruation. 
Postmenarcheal girls, however, were cautious and anxious 
about embarrassment and about the opinions of others 
concerning their menstrual status. The theme of secrecy is 
prominent with postmenarcheal girls, who confessed a desire 
to conceal and hide their menarche as if it were an event 
that triggered shame. 

Newcomer, Udry, and Cameron (1983) used a questionnaire 
to examine the association between peer popularity and 

sexual behavior in a sample of 1405 White and African 
Americans from several junior high schools in a Southern 
urban area. Sample members were 11 to 17 years old with an 
average age of 13.6. White females comprised 38% of the 
sample and 13% were African American females. The results 
showed that those White girls who were most popular with 
boys reported the most sexual experience. African American 
females, however, showed the opposite. That is, African 
American females' popularity with their opposite -peer -sex 
was not associated with more intercourse or with more sexual 
experience. Further, unlike White girls, African American 
girls who were most popular with same -sex -peers were less 
sexually experienced than those girls who had just one 

A review of the literature and related theories about 
menarche were presented in this chapter. The topics 
included age of menarcheal onset, cognition in the child, 
educational preparation, and responses to menarche. The 
next chapter discusses the methods and procedures used to 
conduct the study. 


This chapter presents a review of the methods and 
procedures used in the study. The components of this 
chapter include a description of the (1) research design, 
(2) sample, (3) scientific integrity and rigor, (4) 
protection of human subjects, (5) data collection, (6) data 
analysis and verification, and (7) summary. 

Research Design 

The qualitative case study approach was the primary 
methodological research design used to recruit research 
participants and to collect, analyze, and present the data. 
This is a naturalistic design that is emergent, recursive, 
and useful for illuminating basic social and psychological 
processes (Burawoy et al., 1991; Morse, 1992) essential to 
inductively (re) constructing theory (Yin, 1994). The 
naturalistic design is also referred to as the qualitative 
method (Marshall & Rossman, 1999) . A distinct feature of 
this design is that the researcher has no intent to 
introduce interventions. Its aim is to describe events as 
they occur, naturally. 

Case study research under the qualitative paradigm is a 
detailed examination of one setting, or one single subject, 
or one single depository of documents, or one particular 


event (Bogden & Biklen, 1982; Yin, 1994). It is the 
preferred research method for answering "how" or "why" 
questions, or for examining events over which the 
investigator has little or no control. It is also used for 
focusing on a contemporary phenomenon within some real -life 
context. The qualitative case study design is driven by the 
belief that reality is complex, constructed, and ultimately 
subjective (Burawoy et al . , 1991; Duffy, 1987; Leininger, 
19 85) . As a result, the case study approach allows an 
investigator to retain the holistic and meaningful qualities 
of real -life events. Thus, menarche was the one particular 
event on which data were collected from 30 African American 
females to answer "how" or "why" questions regarding their 
menarcheal experiences. 

Sandelowski, Davis, and Harris (1989) noted the case 
study design is selected when there is an apparent knowledge 
deficit about a phenomenon because of perceived biases or 
omissions concerning what is known. Previously, several 
researchers omitted 9/10 -year-old African American females 
from empirical studies concerning menarche (Belsky, 
Steinberg, & Draper, 1991; Grief & Ulman, 1982; Jones & 
Mussen, 1958; McGrory, 1990; Moffitt, Caspi, Belsky, & 
Silva, 1992; Moore, 1995; Stone & Barker, 1939). A few 
contemporary researchers have made efforts to address this 
knowledge deficit about the menarcheal experiences of 
African American females (Dashiff, 1992; Lee, 1994; Scott, 

Danette, Panizo, & Roger, 1989) and other non-White girls 
(Du Toit, 1987) . Further, the qualitative case study 
approach has never been used as the primary method of data 
collection with 9/10 -year-old African American females at 
the time of their menarche to answer the "how" or "why" 
questions about their social and psychological responses. 

Lastly, many research scholars commonly confuse 
qualitative case studies with ethnographies (Fetterman, 
1989) or with participant -observation studies (Jorgensen, 
19 89) . The word ethnography is derived from the Greek word 
ethno, which means portrait of people; thus, ethnography is 
the study of a cultural scene, group, or setting (Burns & 
Groves, 1997) . The purpose is to describe a folkway and 
mores through examining various cultural characteristics 
(Burns & Groves, 1997) . Generally, ethnographies command 
that investigators spend considerable time in the "field" 
while recording observational evidence (Burawoy et al . , 
1991) . 

Participant -observation also commands a hefty 
contribution of "field" efforts, but the investigator acts 
as a participant while observing and recording data. On the 
other hand, the case study approach does not depend solely 
on ethnographic or participant -observer data. Depending on 
the topic, a valid and quality case study could be done 
through a telephone interview or the theoretical examination 
of a research instrument. These approaches are not possible 

with ethnographic or participant -observer qualitative 
studies (Yin, 1994) . 

The population for this study included a sample of 30 
African American females in a rural Southern community in 
central Florida. Purposive sampling permitted the 
investigator to locate participants who were able to 
communicate in a "focused conversation" about their 
experiences to menarcheal onset. The demographics of the 
final sample of participants are indicated in Table 3-2. 
But before the recruitment of final participants, a 
feasibility study was conducted. 
Feasibility Study 

A feasibility study was done from July to September, 
1996 to learn if an adequate number of qualifiable 
participants would be available. This study revealed that 
57 of 83 mother -daughter dyads in the selected community met 
the research inclusion criteria. Of the 57 mother -daughter 
dyads that met the criteria, only one individual verbalized 
her disinterest in the study. She was not included in the 
sample. McGrory (1990) found 67 of 162 mother -daughters 
refused (42%) to participate in a questionnaire survey about 
menarche in the early adolescent. 

It was originally intended that the fathers of the 
young girls would also be participants in the study. 
However, all fathers rejected the investigator's invitation 

during this feasibility study. One father stated, "Don't 
talk about that stuff around me." Most fathers acknowledged 
the conversation was "woman's talk" and quietly excused 
themselves. Other researchers also found it difficult to 
gain fathers' participation in a "focused conversation" 
about menstruation as a research topic (Amann-Gainotti, 
1986; Moffitt, Caspi , Belsky, & Silva, 1992). Usually 
mothers are the first to know from their daughters that they 
have started to menstruate and seldom do fathers learn 
first-hand from young girls about their menstrual onset 
(Holmbeck & Hill, 1991; Notman, 1992). Nevertheless, the 
feasibility study for the availability of an adequate sample 
size determined that this Southern rural central Florida 
community was an appropriate site to conduct this 
naturalistic study. 
Family Types 

Family types in the feasibility sample resembled the 
diversified models of families found in present day United 
States (Berardo, 1991; Billingsley, 1992; Willie, 1985). A 
heterogeneity of socioeconomic classes, family-member 
compositions, and marital statuses for this sample are 
contained in Table 3-1. Thirty (54%) of the 56 females 
lived in a nuclear or traditional family structure with both 
biological parents. There were 9 (16%) females living in 
the adopted family design. Two females were legally adopted 
by their maternal grandparents, one by her paternal 

grandparents, one by her maternal aunt, and five by non- 
relatives. The single-parent female-headed household family 
pattern belonged to 13 (20%) females. Only 4 (7%) of the 
females lived in an unofficial foster family structure. 
This type of foster family group consisted of fictive kins, 
which are individuals who have no blood ties to the female 
but are viewed by the child as being close relatives 
(Kornblum, 1997) . Of this foster family type, one female 
lived with her mother's protestant pastor and his wife, 
another lived with her mother's friend, and two of the 
females were "taken in" by families in their neighborhoods 
and were living with them for 3 or more years. 
Socioeconomic Status (SES) 

Socioeconomical status of American families are 
determined by the education and occupation of the head of 
the family and the family's total yearly income 
(Hollingshead, 1949, 1957; Gilbert & Kahl , 1993). The SES 
for the 56 families in this feasibility study consisted of 4 
(7%) at the upper-middle class strata, 13 (20%) with a 
middle class lifestyle, 22 (39%) in the working class, and 
17 (30%) at the working poor level. 

All 4 families at the upper middle class strata were 
nuclear. Parents in this group were professionals with 
college degrees and a combined yearly income over $90,000. 
Middle class families were 4 nuclear, 5 adopted, 1 single- 
parent, and 3 foster. The middle class families had a 

yearly income of at least $40,000, and they worked in lower 
management and semiprofessional positions. The yearly 
income of families in the working group was about $25,000 to 
$30,000 for clerical and low-paid sales/craft work. There 
were 1 foster, 7 nuclear, 4 adoptive, and 10 single-parent 
families in the working class group. Fifteen (50%) of the 
nuclear families were working poor in service and low-paid 
clerical jobs with a yearly income below $20,000. Also, 
there were 2 single-parent female-headed families at the 
working poor stratification level. 

Table 3-1 

Profile of Feasibility Sample's Tvp ps 
of Families and Socioeconomic Classes 
































Sampling Procedures 

After this research study was approved by the Committee 
for the Protection of Human Subjects at the University of 
Florida on April, 1997, the researcher began its 
implementation. Sampling procedures in this research were 
conducted in 3 phases. 

Phase 1. In phase 1, the community's County School 
Board was contacted for a copy of the "Directory of 
Information" (See Appendix A) . This directory was used to 
secure the names and addresses of 9- and 10 -year-old African 
American females. Assistance from the elementary school 
counselors was obtained in identifying females who were 
members of the African American racial -ethnic group, which 
was necessary because demographic data about race and 
ethnicity were not included in the school's Directory of 

Phase 2 . At phase 2, the investigator made every 
attempt to contact the mothers of young girls by telephone 
to inform them of the study and to set up an appointment 
with them to discuss its purposes in greater detail. In 
situations where the mothers did not have telephones, the 
investigator visited the homes of potential participants. 
The investigator presented the purpose of the research and 
discussed its components with the mothers. These discussion 
ranged from 30 minutes to 2 hours. Importantly, the nature 
of the study, its purpose, the interview session, the 

recording of information, and data storage and analysis were 
explicated. Both the young girl and her mother participated 
in these discussions about the study. After the mother and 
daughter had agreed to participate, and signed the consent 
and assent forms, the researcher presented the Demographic 
Data Form (Appendix B) that was completed by the mother - 
daughter as requested. Only 22 of the 56 mother -daughter 
dyads from the feasibility study proceeded to this phase of 
the study. 

Attrition of participants occurred, because several of 
the girls were in Tanner's (1978) fourth stage of puberty 
development and had started menstruating before UFIRB was 
secured in April, 1997. Potential early maturing 
participants from the feasibility study were also lost due 
to their families moving from the area. Lastly, some of the 
girls had birthdays that placed them out of the age period 
for this study. 

To continue as potential participants, 9- and 10 -year- 
old African American females must have had been in Tanner's 
(1978) puberty stage 3, 4 or 5. Tanner's stages of puberty 
are generally viewed as predictive of menarche readiness and 
are based on physiologic changes, such as growth of pubic 
hair and breast development. In most healthy girls, 
menarche follows 6 to 12 months after the height spurt and 
after breasts and pubic hair have developed to Tanner's 
fourth stage. With the aid of pictures of genital hair 

growth, the appearance and amount of hair in a female's 
genital region was determined by self -report and validated 
by the mother. 

The criteria for inclusion of the 9/10 -year-old female 
participant were: (1) Signs of first menstruation 
readiness, such as protruding or bulging breasts and an 
ample amount of pubertal hair development in the genital and 
armpit regions; (2) a consistent mother figure or female 
guardian for at least six months and one who was willing to 
participate in the study; and (3) the absence of a self- 
reported known or diagnosed health disorder that might have 
contributed to the delay or early onset of menstruation. 
Snowball sampling, a chain- ref erral , was used by asking 
Young girls and their mothers to provide the investigator 
with names of their friends, schoolmates, or other relatives 
who might qualify for inclusion in the study (Biernacki & 
Waldorf, 1981; Feagin, 1992; Lee & Sasser-Coen, 1996). 

Phase_3.. Phase 3 was the final stage of the sampling 
procedure. Potential participants were contacted by phone 
or in person at their homes on a weekly basis to learn of 
the young girl's menarcheal status. Also, potential 
participants were encouraged to call the investigator at the 
onset of the young girl's menarche. Participant recruitment 
ceased when a total of 3 interviews were completed and a 
core social psychological theme (living throught private 
time) was discovered. The information gathered from the 

participants reached redundancy and saturation of the 
conceptual domains (symbolic bleeding, regualting sexual 
behaviors, and managing menstrual flow) once a core theme 

Sample size . The study consisted of 30 participants 
(15 mothers and 15 daughters) . Quantitative approaches 
often require the use of a large sample size for statistical 
purposes (Yin, 1994) . Qualitative research, on the other 
hand, employs sample sizes that are small and may range from 
a single subject case study to fewer than 30 participants 
(Marshall & Rossman, 1999; Strauss & Corbin, 1990) . 

Several nurses reported the use of fewer than 30 
participants in qualitative research reports. In Iceland, 
Sveinbjarnardottir and de Casterle (1997) used "a sample of 
9 families, 18 family members - that is, 2 members in each 
family" (p. 47) to study the qualitative experiences of 
family members of the seriously mentally ill. Lee (1994) 
used a feminist approach in interviewing 28 postmenarcheal 
women of 18 to 80 years old while exploring meanings they 
attributed to menarche. Through the use of the Heideggerian 
phenomenological approach, Rather' s (1992) sample of 15 
registered nurses completing their baccalaureate degrees 
described their education experiences. Wilkinson & Pierce 
(1997) used a sample of 8 depressed 55/75 -year-old women to 
examine aloneness through face -to -face interviews. A 
qualitative dissertation at the University of Florida's 

College of Nursing (UFCN) completed by Nwoga (1997) 
consisted of "8 mother -daughter dyads formed out of 11 
mothers and 9 adolescent daughters" (p. 96). Other UFCN's 
qualitative dissertations were also implemented with small 
sample sizes (Devers, 1994; Martin, 1995) . Based on the 
traditional and contemporary use of the qualitative study 
design, and the purposes of this research, it was determined 
that 3 research participants were adequate (Burns & Groves, 
1997; Marshall & Rossman, 1999; Yin, 1994). 
Demographic Information 

A profile of the final sample of African American girls 
and their parents are provided in seven Tables. Fifteen 
young girls and their mothers (15) comprised the study's 
final sample of 30 participants. Fathers' demographic data 
and responses were obtained from the young girls and their 
mothers. A four-digit identification (ID) number is used to 
identify a participant. ID numbers in Tables 3-2, 3-3, and 
3-4 are the same. This ID numbering system enables a reader 
to identify a young girl in Table 3-2 and relate those data 
with her parents' data in Table 3-3 and her family type in 
Table 3-4. Table 3-5 provides a profile of the young girls' 
family types and socioeconomic grouping according to 
Hollingshead's Index (1949, 1957). Gilbert and Kahl (1993) 
also use Hollingshead's Index to describe present day 
America's class structure. 

Table 3-6 presents a comparison profile of biological 
fathers' presence and absence in the home to the family's 
socioeconomic classification. Frequencies and percentages 
of the young girls' Tanner's stage of pubertal development 
and their family types are presented in Table 3-7. A 
summary of the demographic variables are provided in Table 
3-8 and includes the mean, standard deviation, minimum, and 
maximum. The summary, frequencies, and percentages were 
done with the Statistical Analysis Series, Windows, 6.12 
(See Appendix D) . 
Early maturing girls 

Table 3-2 presents a profile of the 15 African American 
female participants who are ages 9 and 10 years old. Four 
of the young girls experienced menarche by age 9 years. In 
most healthy girls, menarche follows 6 to 12 months after 
the height spurt and breasts and pubic hair have developed 
to Tanner's fourth stage (Tanner, 1978). Eleven (73%) girls 
reported puberty development was at Tanner's stage four on 
entry into the study; they were in the study from 2 to 12 
months. The length of time young girls were in the study 
for menarcheal appearance ranged from 17 days to 13 months. 
One (7%) girl, age 10 years, at Tanner's stage 5 with a 
height of 65 inches and a weight of 110 pounds had the 
shortest stay in the study which was 17 days. Table 3-7 
shows that 7.2 months was the average length of stay in the 
study among the sample of young girls. The young girls' 

averaged an height of 60 inches and a weight of 97 pounds. 
Three (75%) of the four girls who were 9 years old at 
menarche lived in nuclear families with their biological 
mothers and fathers. 
Mothers and fathers 

Demographic data about the mothers and fathers of the 
young girls are listed in Table 3-3. The mothers ranged in 
age 26 to 55 years. The age range for fathers was 29 to 59 
years. Most mothers (93%) completed the first 12 years of 
education and earned a high school diploma. One of the 
mothers had an earned master's degree and one year of 
doctoral education. Two mothers achieved 2 to 3 years of 
college education beyond the high school level. Ten (67%) 
of the fathers had high school diplomas and two completed 
their baccalaureate degrees at four-year universities. 
Table 3-7 lists mothers with a mean age of 38.4 years and a 
mean education of 12.7 years. The mean age for fathers in 
Table 3-7 is 44.5 years and their mean education is 11.7 
years. The yearly household income for this sample of 
participants ranged from as little as $4,000 to as much as 
$107,000. The sample's average household income is 
presented in Table 3-7 as $39,800. 
Family characteristics 

A profile of the young girls' families is contained in 
Tables 3-4, 3-5, 3-6 and 3-7. Nine (60%) of the young girls 
(See Tables 3-4 and 3-7) lived with both of their biological 

parents in nuclear families. One (7%) of the nuclear 
families, biological parents and two children, was at 
Hollingshead 1 s socioeconomic level for the upper-middle 
class. Of the remaining nuclear families, 4 (27%) had 
middle- class incomes, 3 (20%) had incomes at the working- 
poor status, and 1 (7%) was at the poor income 
stratification. The number of individuals living in a 
nuclear family household ranged from 4 to 6 members. 

Families in Table 3-4 with absent -biological -fathers in 
the home environment were of various types. Two (13%) young 
girls lived with their maternal grandparents as adopted 
children at the middle- class income level. There were 3 
(20%) mothers who lived as single-parent families, 2 lived 
on what Hollingshead considered poor incomes and 1 was at 
the working-poor income level. Both of the poor income, 
single-parent families, lived in households with 
multigenerational family members, one with 12 members and 
the other with 9 other dwellers. The third single-parent 
lived with her male- friend as a cohabitation family on a 
working-poor income. One foster-care family with four 
household members lived on a working -poor income. 

Scientific Integrity and Riaor 
Empirical reports must respond to canons of quality 
(Burns, 1989; Yin, 1994). For many research scholars, the 
qualitative case study is a less desirable form of inquiry 


Table 3-2 


ic Prof 

ile of 


Youna Girls 



ID Number . 

Aqe, Tanner's 

Staae. Time 

in Studv, and 







Time in 






2 mos. 






7 mos. 






5 mos . 






11 mos. 






12 mos. 






2 mos. 






3 mos. 






7 mos. 






7 mos. 






13 mos. 






17 days 






12 mos. 






8 mos. 






9 mos . 






10 mos. 




Table 3-3 

Demographic Profile of the Parents Including ID Number. 
Mother's Age, Father's Age, Mother's Education, Father's 
Education and Household Income 

ID Mother's 

Number Age 

Father's Mother's 
Age Education 

Father's Household 
Education Income 















































































1000 + 












#: Legally adopted by maternal grandparents. Data represent maternal 
grandparents' profiles. 

*: Multigeneration of family members living in same household. Data 
represent ages and grade levels of biological fathers who are not livina 
with the mothers and girls. SES is based on mother's income. 

+: Cohabitational family; mother living with male- friend. Data represent 
age and grade level of mother's male friend. p : 

<>: Foster -care family; data represent foster parents. 


Table 3-4 

Profile of the Young Girls' Families Including Family Type. 
Socioeconomic Status, and Number in Household 




Number in 



























Working -Poor 




Working -Poor 




Working -Poor 





























Working -Poor 



rnHp • 



Working -Poor 


#: Legally adopted by maternal grandparents. 

*: Multigeneration of family members living in household. SES is 
based on mother's income. 

+: Cohabitational family; mother living with male-friend. 

0: Foster-care family. 

ABF: Absent-biological -father. 


Table 3-5 

Profile of Fami ly Types and Socioeconomic Classes According 
to Holl inashead's Index (Gilbert & Kahl , 1993) 





























Table 3-6 

Profile of Biological Fat her's Presence and Absence 
in the Home and .Socioeconomic Class Stratification 







(Nuclear Families) 

1 (7%) 

4 (27%) 

3 (20%) 
1 (7%) 
9 (61%) 



(Non-Nuclear Families) 


2 (13%) 

2 (13%) 
2 (13%) 
6 (39%) 

Table 3-7 

Frequency and Percent of Variables Tanner's Stage. 
Family Type, and Socioeconomic Status (SES) 



Tanner's Stage 









Family Type 






Status (SES) 



Working -Poor 






Table 3-8 

Summary Measures of the Demographic Variables 











Time in 















Mother ' s 





Father' s 





Mother ' s 





Father' s 










Number in 





than experimental and correlational quantitative studies 
(Lincoln & Guba, 1985; Yin, 1994). A group of five 
prominent statisticians at Harvard University stated: 

most people feel that they can prepare a case 
study, and nearly all of us believe we can 
understand one. Since neither view is well 
founded, the case study receives a good deal of 
approbation it does not deserve (Hoaglin, Light, 
McPeek, Mosteller, & Stoto, 1982, p. 134). 

Most researchers recognize the politics of knowledge, or the 
ways certain knowledge is privileged and gains credence, 
thereby marginalizing other forms or sources of knowledge. 
Nevertheless, Lincoln and Guba (1985) point out that 
qualitative researchers must establish the "truth value" (p. 
290) of the study, its applicability, consistency, and 
neutrality, which are terms matching the positivistic 
paradigm's internal validity, external validity, 
reliability, and objectivity. To assure rigor, Yin (1994) 
agrees that case study investigators must maximize these 
four aspects of a research design. 

Several measures to ensure the overall integrity and 
rigor of the study were employed, and they included: 

(1) Triangulation of types of information (attitudes 
and perceptions, symptoms and mood, and behaviors) and data 
collection that involved (face- to- face interviews with the 
9/10 -year olds and their mothers) . 

(2) Continuous validation with the mother -daughter dyad 
and members of the dissertation supervisory committee 

provided validity about the data and the coding categories 
generated from the data. 

(3) Multiple mother -daughter (30 participants) dyads were 
included in the study. Yin's (1994) position about 
qualitative case study design, suggests that each 
participant's interview in this study was the subject of an 
individual case study, and the study as a whole was a 
multiple- case study design. 

Generalization is a common concern about case studies, 
which is best addressed through the use of the multiple- case 
study design, sometimes referred to as extended- case 
approach. Yin (1994) asserted that scientific facts are 
rarely based on single experiments; they are usually based 
on a multiple set of experiments, which replicated the same 
phenomenon under different conditions. The identical 
thoughts and approaches are used with multiple -case studies. 
That is, multiple numbers of qualitative case studies were 
replicated around menarche with 9/10 -year old African 
American girls and their mothers from different home 
environments. Qualitative case studies, like quantitative 
experiments, are generalizable to theoretical propositions 
and to populations or universes. In this sense, the case 
study, like the experiment, does not represent a sample. 
The qualitative case study investigator's goal is to expand 
and generalize theories (analytical generalization) and not 
to enumerate frequencies (statistical generalization) . 

Thus, the researcher's goal is to complete a generalizing 
and not a particularizing analysis. 

Protection of Human Subjects 
The research protocol for this study met the approval 
of the University of Florida's Institutional Review Board, 
IRB #127-97 (Appendix A). Recruitment of participants and 
data collection and management procedures were followed as 
described by the approved research protocol . 

Participants, as research subjects, were informed of 
their rights including their right to withdraw from this 
study at any time. Telephone numbers of the University of 
Florida's Institutional Review Board and the principal 
investigator were listed on the Informed Consent Form (See 
Appendix A) . All participants signed and dated the Informed 
Consent Forms. Mothers were given a copy of the Informed 
Consent Form, and it was recommended that they keep the Form 
for their records. They were also advised to contact the 
researcher if any questions or concerns developed. 

Confidentiality of participants was maintained. The 
use of four-digit identification code numbers selected by 
the participants protected their privacy during recording 
and transcribing of the audiotape interviews. The 
investigator erased audiotape interviews at the completion 
of the typed transcription. At this time, all tapes have 
been erased. 

Data Collection 

Interviewing is an essential feature of the qualitative 
case study method and in-depth interviews are often used as 
the leading method of data collection (Marshall & Rossman, 
1999; Shaffir & Stebbins, 1991; Yin, 1994). However, many 
qualitative case study investigators use surveys, 
questionnaires, and demographic inventories to enhance the 
type of data collected and to increase the general 
robustness of the study's design (Feagin, Orum, & Sjoberg 
1991; Sandelowski, Davis, & Harris, 1989) . 

A working list of questions (See Appendix D) were used 
to guide the "how" or "why" questions in a "focused 
conversation" interview with each mother and daughter dyad. 
Through the use of in-depth mother -daughter interviews and 
the demographical inventory, triangulation of data were 
achieved (Yin, 1994) . These techniques are consistent with 
the naturalist paradigm and the qualitative case study 
research design (Willie, 1985; Yin, 1994). 

Minimally structured conjoint mother -daughter 
interviews were planned. Conjoint interviews about private 
and sensitive topics are preferable to private interviews, 
because they foster a climate of openness and trust 
essential to the success of a family study, allow mutual 
corroboration or correction of information offered to the 
interviewer, and reveal patterns of family members' 

interactions (Kvale, 1996; LaRossa & LaRossa, 1981) . Mother 
and daughter, rather than individuals, represented an 
important "natural" unit of study for this research (Burns 
and Grove, 1997; Sandelowski, Davis, & Harris 1989; Yin, 
1994) . 

A general theme with ah open-ended question was 
introduced, which focused the mothers' and daughters' 
thoughts while allowing freedom of expression (See Appendix 
D) . The substance and direction of each interview varied 
with the mother -daughter responses. The general theme of 
the interview was the participants' responses to the (a) 
meaning of menarche, (b) effects of menarche on family 
members' roles and statuses, and (d) the effects of menarche 
on the young female's body and her self-image. 

During the interview, the initial question was, " what 
does it mean to have your first period?" The major working 
research questions at the outset of this project were: (1) 
How do African American girls ages 9 and 10 years old think 
and feel about starting their first menstrual? (2) How do 
African American parents react to the menarcheal onset and 
reproductive capability in their daughters who are 9 and 10 
years old? (3) How do 9/10 -year-old African American girls 
manage the care of their first menstrual flow? and (4) What 
changes manifest in African American family members' 
relationships with each other around the onset of menarch in 
girls ages 9 and 10 years? 

Probing questions and reflective statements were used 
to direct the interview, to elicit information about the 
timing and details of the menstrual event, and for further 
explanation and clarification. Silence was used to 
encourage the participants to fully express themselves 
before additional probes were introduced. Tracking served 
to minimize interference with the natural flow of 
conversation. Participants were redirected to the tracked 
topics only after they finished expressing their thoughts. 
As the study proceeded, the interviews became more or less 
structured depending on the content of the focused 
conversation and the mother -daughter dyad reactions. 
Lastly, directed interviewing was necessary to validate 
data, and it occurred at the end of the interviews. 

The duration of these interviews averaged 60 minutes. 
All interviews took place in the participants' homes and at 
their convenience. Because of increased hormonal levels 
affecting a female's emotional state within 7 days of 
menstrual flow cessation (Guyton & Hill, 1996; Tanner, 
1978) , home visit appointments were scheduled no later than 
2 to 5 days after the completion of the young girl's 
menarcheal flow. Most of the interviews occurred during the 
weekends, as requested by the mothers. As a show of thank 
you, a ten dollar gift certificate for the young girl and 
one for her mother to J.C. Penney 's or a comparable store 
was presented at the end of the interview session. 


A mother -daughter dyad could have been in the study for 
17 days to 13 months before the appearance of the young 
female's first menstrual flow (See Table 3-2). Recall that 
it was only after the appearance of the young female's first 
menstrual flow that the interview was conducted. All 
interviews were audiotaped and transcribed verbatim by the 

Data Analysis and Verification 

A variety of qualitative and statistical techniques 
were used to analyze the data and to verify explanations of 
the data. Cross-case analysis emphasized the description of 
social psychological and familial processes occurring within 
each mother, daughter, or dyad. Descriptive statistics were 
used to provide summary profiles of the studied 
participants . 

Qualitative cross-case data analysis of interviews 
began with substantive coding, and initial reduction of data 
in which the substance of the interviews were summarized 
without imposing any theoretical construction on the data 
(Burns & Groves, 1997; Marshall & Rossman, 1999; Yin, 1994). 
Substantive coding evolved into theoretical coding when 
relationships between substantive codes were discovered and 
theoretical linkages were made to contain, describe, and 
explain the data (Burns & Groves, 1997) . 

Analytic and process memos were maintained throughout 
the project in order to document changing views of the data. 

Analytic memos are notations of ongoing efforts to 
"theorize" about the data. Process memos are notations 
describing observations about participants ■ behaviors and 
interactions and about the investigator's behaviors while 
interacting with the participants and making decisions 
regarding the conduct of the study (Glaser & Strauss, 1967; 
Marshall & Rossman, 1999) . 

The technique of constant comparison was employed to 
unveil the core agency that accounted for most of the 
variation in the data and that integrated the data, codes, 
and analytic and process memos accumulated during the course 
of the study (Glaser & Strauss, 1967; Yin, 1994) . This 
method involved moving back and forth among data sets to 
discover patterns and to determine the presence, variation, 
or absence of patterns. "Living through private time" was 
the core social psychological category that was gleaned from 
these data basic to the mother - daughter ' s move into the 
menarcheal experience. 

Participants completed a demographic data sheet (See 
Appendix B) . These data were primarily used to determine 
participants' socioeconomic status. Also, this form 
provided the name, address, and phone number of participants 
for ease in contacting them about the young girl's 
menarcheal status. It also contained physiological data, 
such as the age, height, weight, and presence of breasts and 
genital hair, which were used to determine the young girl's 

stage of menarcheal readiness (Tanner, 1962, 1968, 1978, 
1981). This description explicates the mother's and the 
daughter's experiences regarding the daughter's menarche. 

A description of the qualitative case study research 
design was presented in this chapter. The feasibility study 
and the three-phase sampling procedures were discussed. A 
rationale was given for a sample size of 30 participants. 
Demographics of the final sample of 3 participants with 
tables were described. Data collection and analysis were 
explained. Scientific integrity and rigor were highlighted 
in this chapter as significant features of the qualitative 
paradigm. The next chapter presents participants' 
narratives and "living through private time" as the core 
social psychological theme. 


"Living through private time" is the core social 

psychological theme that describes life at menarcheal onset 

for 9/10 -year-old African American females and their 

parents. As the result of a cross -case analysis of multiple 

interviews, "living through private time" emerged 

inductively. The interview data obtained from the young 

girls and their mothers support symbolic bleeding, managing 

menstrual flow, and regulating sexual behavior as the major 

conceptual domains undergirding "living through private 

time." Interpretations of participants' interview 

statements are provided for an understanding of "living 

through private time" and its three conceptual domains. 

Organization of the Chapter 

The organization of this chapter follows the pattern of 

a major conceptual domain being defined with properties of 

the domain being explicated as subthemes. Interview 

statements obtained from the young girls and their mothers 

are dispersed throughout the subthemes and are used to 

elucidate the defining properties within a domain of living 

through private time. It is at the descriptive level of the 

subthemes where specific "how" and "why" questions are 


answered relative to the social psychological responses and 
practices of young girls and their parents regarding the 
menarcheal onset in the 9/10 -year-old African American 
females. Fathers' responses are reported in statements 
received from the early-maturers and their mothers. 

Symbolic Bleeding 
Symbolic bleeding is the leading conceptual domain 
supporting "living through private time." This conceptual 
domain is governed by participants' philosophical beliefs 
and values held regarding females' experiences with 
menstruation. Symbolic bleeding gives a conceptual view 
into the social psychological and interactional lives of 
menarcheal girls with their parents. The subtheme 
properties of symbolic bleeding are philosophical beliefs, 
emotional responses, at another time, sexual sensuality, and 
private business. This conceptual domain, symbolic 
bleeding, was the antecedent for subsequent responses and 
behaviors as parents and daughters interacted over 3 to 7 
days during the young girls' first menstrual flow. 
Philosophical Beliefs 

Mothers . From the perspective of many mother 
participants, menarche symbolizes childbearing capabilities, 
increased interest in boys, and a potential for decreased 
interest in education. Based on these beliefs, mother 
participants changed their conversational and interactional 
behaviors with their early maturing daughters. Mother 

participants realized that they needed to show an awareness 
of the increasing sexual sensuality and reproductive 
capability of their daughters' maturing bodies. This 38- 
year-old mother of a 10 -year-old daughter stated: 

It changes her from childhood to womanhood, 
because now she is capable of bearing children, 
which we don't want right now. I try to tell her, 
"Now look, boys are different." I said, "But now 
you are going through a part of your life where 
now you can actually have a b-a-b-y. Babies, 
boys, and books don't mix. But now you've started 
your period and you can get pregnant. So don't 
let any little boy tell you, "Oh if you love me, 
you'll do this, you'll do this." No! Always, I 
try to express to my girls, save yourself, better 
to wait. There is no hurry. 

(ID, 0201) 

The onset of menstruation, according to this mother, 
changed a nonreproductively capable young girl from a child 
to a "woman" who is able to get pregnant and give birth to 
her own child. For this mother, females who are capable of 
getting pregnant have reached "womanhood." On the other 
hand, she emphasized that "womanhood" for a newly 
menstruating 10 -year-old girl does not imply adult maturity 
to the level of independence from parental nurturance, 
guidance, and discipline. She discussed knowing that a 
newly menstruating girl of 10 years old remains a young 
child requiring parental directions and guidance about the 
values of being academically focused. Further, she 
described the perils of being cajoled and wooed by boys into 
sexual intercourse activities for which they are too young 
to "handle." 

Beyond menarche, many early maturing girls experience 
irregular flows for months before establishing a regular 
cycle of menstruation. Menarche marks uterine maturity but 
it does not necessarily represents reproductive maturity 
(Guyton & Hill, 1996). Early menstrual cycles are often 
time irregular and between 55% and 82% of menstrual cycles 
during the first 2 years occur without ovulation (Golub, 
1992) . Since ovulation is required for conception, some 
girls may not be reproductively capable for one or two years 
after initiating their first menstrual cycle (Guyton & Hill, 
1996) . However, mother participants felt that there is 
always the possibility that an early maturer engaging in 
sexual intercourse could become pregnant. Parents in this 
study tended to interpret the appearance of their daughter's 
menarche as a sure sign of pregnancy capability and sexual 
interest in boys. This 37 -year-old single mother living in 
a cohabitational family lifestyle stated: 

The period means she can get pregnant. The whole 
idea of her seeing her period... That's the whole 
idea. You never know. Because you know girls 
like boys and everything. But you never know what 
they do behind your back. The meaning of the 
period to pregnancy and put all that on top of 
being a child, this is what I'm talking about. 
Yes, I'm concerned. I don't want nothing to 
happen. You know boys will tell you, "Oh, I like 
you and I like you and everything, and blah, blah 
this and that." Next thing, boom! I got a 
grandbaby. The period means she can get pregnant. 

(ID, 1000) 

This participant addressed why mothers must be 
insightful about boy- girl sexual interest and intimate 
relationships. She stressed that mothers must acknowledge 
their understanding of and beliefs about menarcheal onset to 
pregnancy possibilities. Once young girls and boys, 
according to this mother, are able to enjoy each other's 
company clear of parental supervision, the possibilities of 
sexual intercourse and pregnancy occurrences increase. 
After all, girls do like boys. But girls and boys can learn 
to enjoy each other's company without engaging in sexual 
intercourse. Behaviors such as holding hands, hugging, 
playing board games, and enjoying intellectual activities 
are but a few of their options (Hartup, 1992; Maccoby, 
1990) . Mothers and fathers will need to articulate these 
expectations and support these manifested behaviors 
(Bronfenbrenner, 1997; St. Jean & Feagin, 1998). 

Fathers. Stimulation of erotic zones encourages sexual 
desires and urges (Guyton & Hill, 1996; Rubin, 1990) . 
Sexual foreplay and intercourse serve as neural messengers 
to the brain (Guyton & Hill, 1996). Thus, once neural 
signals are received by the brain from an erotically aroused 
region of the body, appropriate hormones are released and 
eventually act on sexual and reproductive body parts. From 
these points, some of the girl participants' fathers 
believed that continued stimulation of erotic body regions 
in young girls over a period of time encouraged early 
pubertal maturation and menarcheal onset. 

An absent -biological -father used the biophysiological 
thesis to express his belief to his child's mother about why 
their daughter experienced menarche at an early age. The 
single mother living in a multigenerational home with their 
10-year-old early-maturer stated: 

She's well developed. Her dad blames me because 
he believes that a little boy been messing with 
her. [Investigator asked: "Messing with her? 
You mean...?"] Having sex and feeling over her 
body; this gets it (menstrual flow) started. 
That ' s what he says . 

(ID, 6289) 

Some fathers indicated to mother participants that when 
menarche occurs in a 10 -year-old girl, it symbolizes early- 
age participation in sexual intercourse. This mother made 
it clear that her daughter's father held the belief that 
early menstruation and physical development come about when 
boys are allowed to feel and touch a young girl's body in a 
sexually sensual manner. According to this mother, the 
father believed she was to blame for the early onset of 
menarche appearing in their 10 -year-old child. For the most 
part, it is believed that mothers are the -keepers -of - 
children, especially girls (Baumrind, 1993; Bronf enbrenner, 
1997; St. Jean & Feagin, 1998). As such, some fathers will 
have mothers shoulder the responsibility of making sure 
their daughters do not become involved in sexual activities 
in any way. When there is "proof," such as menarcheal 
onset, that a child is sexually involved, a father will most 
likely point- finger- in-blame at mothers. 

Good fortune falls short in the face of those who 
consciously take advantage of others for selfish reasons and 
without good intent. In such situations, revenge is 
inevitable, comes in many forms, and is hard to accept. 
Usually, the reprisal simulates the harm inflicted upon the 
victim. Fathers who as young boys took advantage of young 
girls for sexual fulfillment may fear their daughters will 
also be used by males in a similar fashion. A single mother 
had this to say about an absent-biological- father ' s reaction 
to their 10-year-old' s experience with menarche: 

Her daddy is having a hard time accepting it. She 
is his little girl. He feels guilty about all the 
wrong he has done to other people's daughters and 
feels that payback is going to come in the form of 
some boy or man trashing his daughter. He is 
really having a hard time with this. You know how 
men are. Plus, she is just very young. 

(ID, 5483) 

It is believed by some fathers that when they sexually wrong 
the daughters of other fathers, they must prepare for their 
daughters to endure a similar fate. Menarcheal onset in 
early maturing girls can symbolize a notice of imminent 
revenge awaiting such fathers as this mother described. A 
feeling of guilt looms over a father who knowingly "trashed" 
another father's daughter. Fathers guilty of using young 
girls as sex objects for pleasure and gratification may 
become nervous and anxious when they learn that their little 
girl is now menstruating. 

Who must know that a young girl has started to 
menstruate is the attitude taken by many fathers. Some 
fathers believe that a young girl's menarche indicates to 
young boys that she is sexually ready and available. As a 
result, some fathers will most likely take a hush, hush 
approach about their daughters' menstrual status. A middle- 
class 55 -year-old maternal grandmother had this to say about 
her husband: 

I told him (child's grandfather) she had started. 
He said, "Woman, do you have to broadcast it? I 
don't want to hear nothing about it. I don't want 
to hear about it." That's him. I said, "Alright, 
okay." Then he said, "Don't you tell nobody 
else." That was that. You see your period, so 
you're ready for sex. That's what a lot of men 
think. So, I guess he doesn't want boys to think 
his [grand] daughter is ready or available for sex. 

(ID, 1844) 

Once boys learn that a girl is menstruating, they 
automatically assume she is ready for sex. From a 
biophysiological position, the act of menstruation requires 
the release of sexually stimulating hormones that trigger 
sensual urges and desires. Many boys believe a menstruating 
girl desires sexual activities even if she is not interested 
in any one particular young male. Once boys learn that a 
girl is menstruating, she is tagged as a potential candidate 
to fulfill their sexual desires. Most fathers are not 
remissed about how boys think, feel, and act toward 
menstruating girls. Silence about the menarcheal status of 
early maturing girls is a common belief and practice for 
many fathers. 

Earlv-maturers . Mothers and fathers reacted to the 
onset of their early-maturer ' s menarche based on their 
understanding of and life -lived experiences around the 
menstrual process. Consistently, the early-maturer 
participants' beliefs about their menarche were in line with 
their understanding of what it means to menstruate. For 
many girl participants, menarche had no special meaning 
beyond bleeding or passing blood from the vagina. Whereas 
mothers and fathers were concerned with the meaning of 
menarche as linked to sex, diseases, pregnancy, and fear of 
retaliation, young girls were mostly concerned about the 
bleeding, or flow of blood. Statements from most of the 
girls about what they thought their menarche meant were a 
simple reply of "I don't know" or "nothing." However, this 
10-year-old middle-class girl from a nuclear family with an 
older sister responded by saying: 

It had no special meaning when I first saw it. It 
meant nothing really... I knew it was my period, 
because it was red like blood. That's what the 
teacher said it would be. I remembered to tell 

(ID, 0201) 

She indicated there was no special meaning attached to the 
first sight of her menstruation. To know that it was her 
menarche was to recall what the teacher said about it. 
Outside of memory about how she should had known when her 
cycle started, menarche beared no special meaning relative 
to sex, pregnancy, or reprisal for father's wrong doings to 
other females. 

After several minutes of thinking about an answer to 
the question related to the meaning of her first menstrual 
flow, this 10 -year-old who had been in the study for 10 
months replied: 

I knew right away what it was . . . I don't know what 
causes it to come. I know I need it to have 
babies. [Breaks out into a loud laugh] . How can 
we (she and her friends) have babies when we're 
just babies? Everybody's talking about don't get 
pregnant, don't have babies. We can't get 
pregnant, cause we are babies. [Mother said with 
a_ firm voice, "Stop that ."]... I 'm sorry. [Softly 
giggled then sat back in chair while ending with a 
smile and folded arms] . 

(ID, 2750) 

While attempting to give a thoughtful answer from what other 
people apparently told her about what it means to 
menstruate, this early-maturer realized from her own belief 
that children cannot give birth to other children. For her, 
it was a laughable notion once she thought about it - babies 
simply cannot give birth to babies. In spite of information 
provided prior to the onset of menarche, she understood and 
believed that her first menstrual flow failed to symbolize a 
child's ability to get pregnant. 

Menarche involves blood flow from the vaginal canal. 
For some early-maturer participants, it was simply bleeding. 
Their understanding of menarche was limited to its meaning 
from a bleeding or biological perspective. The first 
interviewee, 10 years old, commented to a number of singular 
simple questions that generated the following response: 


My period is when I bleed. [Investigator asked: 
"How long did it last?"] I don't know how long 
its supposed to last, but I started on Monday and 
stopped on Thursday. [Investigator asked: "Will 
it come on again?"] I think its going to come 
back again, but I don't want it to come... I didn't 
know what it was when it started... I thought I was 
wetting my pants... I didn't think I had hurt 
myself, but I knew I was passing blood from 
somewhere down there, cause it was in my panties. 
I just didn't understand what it was... The 
teachers talked to us about blood coming from down 
there, but I couldn't put everything together she 
told us. I thought it would just stop. So, I 
just kept changing my panties .. .The next day, mom 
found my dirty pants in the laundry and I had to 
tell her what was happening to me. I told her I 
was bleeding. 

(ID, 1844) 

For this early-maturer, menarche symbolized bleeding. She 
believed that when a young girl bleeds from the genital 
area, she wets her pants. As with this participant, other 
girls also believed the bleeding would stop and never happen 
again. Hence, they managed the bleeding process by lining 
their underwear as best they could with tissue to prevent 
soiling their clothing. Menarche was something that 
"happened" to a young girl and their understanding of why it 
happens is not clear. What they did understand and believed 
was that menarche was a bleeding process about which mothers 
know a lot and young girls know very little. 
Emotional Responses 

Early-maturers. How a person responds to events, 
objects, circumstances and situations depends on associated 
ascribed meanings and beliefs (Blumer, 1969) . Responses 
from young girls under the subheading "philosophical 

beliefs" about menarche show that early maturing girls may 
have a limited understanding about what the menarcheal 
process involves. However, most early maturing girl 
participants were fully aware of the bleeding or blood 
involved with menstruating. Passing blood, or bleeding, 
from the vaginal area was emotionally profound and 
embarrassing for early-maturer participants. As a result, 
crying was a common emotional response for 8 of the 15 girls 
in this study. Most of the girls were reserved about how 
they felt about starting their menstrual cycle and gave one- 
word answers that included, for example, "scared," 
"ashamed," "disgusted," and "embarrassed." Some girls said 
they felt "nothing." A few girls replied, "I don't know," 
as an answer to the question addressing their emotional 
responses about how they felt about starting their first 
menstrual flow. 

Girls who were more vocal about their feelings than 
others described "why" they experienced specific emotions 
about menstruating. This 10-year-old girl who was in the 
study for 9 months prior to menarche stated: 

I just know I don't like it. Its blood and it 
smells. I had to take lots of baths and change 
pads and panties. The pad was bulky and 
uncomfortable. I just don't want it to come 
anymore. My mama was out of town so I told my 
grandma. She said, "Your period started. You 
ain't gotta be afraid. Its just that you're 
developing." I don't like it. 


This narrative identified the fear that the grandmother 
recognized in the early maturer. This early maturer simply 
did not understand the role of menstruation in the 
developmental process of maturing into "womanhood." What 
she did understand, however, was that the menarcheal flow 
was time-consuming and a nuisance. For her, the bloody 
flow, odor, and pads were aggravating and annoying. She had 
to take lots of baths and change sanitary pads and underwear 
on a frequent basis in an effort to avoid adverse body odor. 
As a developing young girl, she prefers to be comfortable in 
her daily attire, but menstrual sanitary pads hindered this 
clothing preference. 

Reflecting, some mothers shared memories of how they 
responded to their menarcheal onset as they helped to 
describe the emotions of their daughters. This 55 -year-old 
mother stated: 

I started when I was eleven. Sure did. I was 
young and didn't have things like that on my mind. 
When it came, it was almost like a shock. I had 
been told, but then I forgot about things like 
that. That was something I felt like I shouldn't 
be worried with at that particular time. I didn't 
think that was going to happen right away. I 
figured it's be down the road awhile. Maybe not 
20 or 21 years old, but 18, 19, maybe... I 
discovered she had started [menstruating] through 
the soiled, wet laundry. I was getting ready to 
do the laundry, and it was wet underwear in there. 
And I thought it was one of the smaller children's 
underwear. I said, "Wait a minute. Whose 
underwear? Who's this?" It was hers. So I said, 
"No, this is hers (older daughter)." Well, she 
didn't tell me anything. So, she must had been 
ashamed, embarrassed, afraid to tell me, or she 
didn't really know what was happening, or why it 


was happening. She didn't come to me and tell me 
anything. I discovered it in the laundry... I had 
mentioned to the teacher that I believed she was 
going to start real soon. I had confided with the 
teacher, but I even told her, but she probably 
forgot. [The teacher] said, "Well, just let her 
know whenever she starts." I have stuff here for 
the girls if they need it. She probably forgot. 
It probably happened so quick that day that she 
just forgot everything I told her about it. Just 
forgot everything. She was embarrassed because 
she really didn't know what was happening. All 
she knew was that her underwear was stained or 

(ID, 1844) 

This mother recalled that she also started menstruating at 
an age as young as 11 years. As an early-maturer, she was 
able to identify with "why" a young girl may not readily 
respond to her menarcheal flow even when taught about the 
process and when provided with biological explanations. For 
this early maturing mother, menarche was something that 
"happened" to an older age girl, not to a girl less than 12 
years old. 

A young girl of 9 or 10 years old may struggle with 
fuzzy- knowledge to comprehend what is happening to her body 
as menarche follows its normal physiological course. It is 
not unusual for some young girls to experience multiple 
emotions while attempting to sort through the earlier 
learned menstrual information received from their mothers 
and teachers. Emotions such as shock, fear, shame, and 
embarrassment overwhelmed many of the early-maturer 
participants' self -concept . For the early-maturer in the 
above narrative, "ignoring" the menarcheal flow by not 

informing the mother or teacher was akin to not 
acknowledging its existence. 

Few girl participants were excited about the arrival of 
their menarche. An older sister who was experienced with 
the menstrual process is in a position to help her early 
maturing sister identify and comprehend menarche on its 
appearance. The mother of a 10 -year-old stated: 

She was excited about it. That morning after they 
(she and her older sister) figured out what was 
happening, she came running to our bedroom door 
yelling [with excitement] , "Mama, daddy, my period 
started!" We were pleased that she handled it so 
well . 

(ID, 5569) 

For this early maturer, menarcheal onset was an exciting 
life experience and accepting with the help of her older 
sister. She felt comfortable about informing both her 
parents without a sense of shame or embarrassment. As 
voiced by the mother in this narrative, they were pleased 
with the fact that she accepted her first menstrual flow 
with joy and excitement. 

Parents . Parent participants' emotional responses to 
their daughters' menarcheal onset were consistent with their 
beliefs about the meaning of menstruation in a 9/10 -year-old 
and with their relationships with the child and each other 
as parents. As with the child, responses for parents were 
varied and numerous, and included fear, apprehension, 
nervousness, and anxiety. One mother (id 5569 in previous 

narrative) identified positive emotions that included joy 
and excitement. 

A 40 -year-old mother of a 9 -year-old early-maturer 

At first I was really apprehensive and scared to 
some degree, myself, with the implications of 
those possibilities of pregnancy and 
boyfriend/girlfriend relationships and things like 
that. But, I think after a couple of days, or so, 
after praying on it and thinking about it, I just 
come to the conclusions that we, as parents, 
adhere to some of the things that we've been 
taught, and go back to the old school of teaching, 
or the old school of thinking, and put trust in 
them. I shouldn't really have that fear. 

(ID, 9533) 

Initially, this parent was apprehensive and scared about her 
early-maturing daughter initiating menstruation. The "why" 
of her emotional responses were associated with the 
possibilities of sexual activities and its ramifications 
occurring in her child who is as young as 9 years of age. 
Her feelings of fear and apprehension required that she used 
a couple of days to think and pray about her young 
daughter's newly acquired menstrual status. Prayer gave her 
moments of mental solitude and privacy for thinking. Thus, 
through mental solitude for privacy, she was able to view 
her daughter's menstrual developmental state from a 
different angle. She indicated that it helps parents to 
pray and trust their child will recall and adhere to moral 
principles taught for guidance around menstruation and 
sexual situations. With prayer and trust, then, this parent 

came to realize that her apprehensive and fearful thoughts 
and feelings soon abated. 

Some mother participants used the biophysiological 
menstrual cycle model to explain the timing of menarche. 
This model supports the thesis that menarcheal onset is 
genetically and nutritionally influenced (Guyton & Hill, 
1996) . That is, a young girl will most likely experience 
menarche at or near the age of onset experienced by her 
mother (Chern, Gatewood, & Anderson, 1980) . Also, those 
girls who are nutritionally developed as exhibited by their 
height, weight, and secondary sexual characteristics, will 
most likely start menstruating prior to 12 years of age 
(Herman -Giddens et al . , 1997). 

Mother participants who initiated menstruation at 16/17 
years were surprised or stunned when their daughters started 
early at 9/10 years. A 35 -year-old mother with a 10 -year- 
old early-maturer who entered the study at Tanner's stage 4 
for pubic hair development stated: 

Well now, she kept saying, "Mom, so and so started 
her period." And it seemed like every week 
somebody in her fourth grade class was having a 
period. So, I said, well, you don't have to worry 
about that cause I didn't start until I was 16. 
Plus she is not big-boned and she is flat-chested 
like me. But pubic hair, she has hair. So, ah, I 
said you have a long ways to go before you have 'to 
worry about a period. I didn't see any signs or 
nothing. This hit [me and her dad] like a brick 
But, she started. So, I had to talk to her about 
it. It's just a total surprise. I think we (she 
and her husband) were more nervous about it than 
she was . 

(ID, 2750) 


As voiced in the above narrative, these parents were simply 
not worried about, or not expecting, their 10 -year-old 
daughter to begin menstruation; they were surprisingly 
stunned when it happened. For them, nervousness was an 
instant response for once they realized their young daughter 
was menstruating. 

Some mother participants were more concerned or worried 
about how fathers would respond to learning about their 
daughters' early menarcheal onset than their own feelings 
about the child's menarche. Recall from responses under 
"the philosophical beliefs of fathers" that some fathers 
responded by blaming the mothers when young girls 
menstruated by 9/10 years old. Some fathers feared their 
daughters would be mistreated sexually by young boys as they 
themselves had wronged so many women. Based on the father's 
behavior, this 26 -year-old single mother of a 10 -year-old 
early-maturer stated: 

I was worried, worried about how he [child's 
absent -biological -father] would react. Like I 
said, he done messed over a lot of women and he's 
afraid payback is coming to him through his 
daughter. But he was the first person to sat on 
my mind... I went to his shop and told him about 
it. People were there in the shop, so he was calm 
about it at that time... He came here (to her home) 
asking me how did it happened... accusing me of 
letting boys have her. [Investigator asked: 
"Sex?"] Yes, sex. That's what I mean. He thinks 
it got started because she been having sex. You 
know some men do believe that. [Investigator later 
learned that this child and another child 
participant with ID 6289 were both involved in 
sexual activities with young boys.] Now, he 


messed over me, you know, but my mother and 
brothers are not after him. But like I said, he 
takes care of her and he spends time with her. 
I'm worried, I guess I'm afraid of what he might 
do to me if she gets pregnant. That's all I can 
think about . 

(ID, 5483) 

The personality and behavioral responses of all acting 
individuals in any given situation can influence how any one 
particular person may respond to an event or object under 
certain circumstances (Blumer, 1969) . The many facets of 
human interrelationships will influence behavioral responses 
in various life situations (Heidegger, 1962) . Men are 
physically stronger than women (Rubin, 1990) . A hostile and 
aggressive male can physically and emotionally harm a 
female. When most women sense that a man will physically 
injure or harm her, they become scared and worried (Swann, 
Langlois, & Gilbert, 1999) . Some fathers who have sexually 
mistreated numerous women may seek to protect the virtuous 
image of their own daughters from other males. From the 
position of some fathers, a 9/10 -year-old menstruating girl 
is not virtuous. A father with such thinking could most 
likely behave in a hostile and aggressive manner towards the 
early-ma turer's mother. Hence, some mothers are more 
worried about how the father of an early-maturer will 
respond towards them than anything else. 

The following remark by a 33 -year -old mother with a 9- 
year-old early-maturer tells how her husband's behavior 
influenced how she and their daughter responded: 


He is all nervous about it and I'm all stressed 
out. I'm nervous too, but he is putting so much 
pressure on me. It is just too stressful. That 
young man talking to her by the fence and 
everything, and now this. These children don't 
need menstruation. They need to be somewhere 
playing, enjoying their life as a child. I know 
its hard on her too, because I can see it in her. 
Sometimes I feel for her, knowing that we are so 
strict and watching her every move and she doesn't 
fully understand menstruation or why her life all 
of a sudden is turned upside down. She knows 
we're trying to keep her from being with boys so 
she can't get pregnant, now she knows this. But 
its too much pressure on me, and I don't think she 
is very happy. I know she is not happy right now. 
He (child's father) will come around. I will pray 
on it and keep talking to him. He'll come around 
and it'll be alright. 

(ID, 7784) 

The mother in this narrative highlighted how a nervous 
father can make both the mother and the female child 
nervous. Also, she honed in on the fact that some mothers 
may feel more nervous and stressed than the father or the 
child when they have the added responsibility of making sure 
the child does not get involved sexually and risk becoming 
pregnant. Pregnancy can create a family crisis (Freeman & 
Rickels, 1993). Parental emotional responses of nervousness 
and stress about the early-maturer ■ s menarcheal onset can 
create an unhappy home environment for the family (Holmbeck 
& Hill, 1991) . 

Many young girls relied on mother participants to be 
near them at the time of menarcheal onset for support and 
guidance. Some mothers were emotionally hurt or had a sense 
of guilt if they were at a geographical distance away from 

their daughters at the time of menarche. Also most young 
girl participants indicated a sense of fear over managing 
the menarche without their mothers' physical presence. This 
37 -year-old mother stated: 

I felt sorry for her. I wasn't here, like, the 
first day, second day, but the third day I was. I 
knew she was scared and she needed me here and I 
wasn't here for her, you know. So, I felt guilty 
and I was hurt, cause I was up the road working 
[Mother is a short -order cook and travels out of 
town with her live -in male- companion for work 
during summer months at the end of fruit 
harvesting season.] She is so immature, very much 
so. Like if something happens, she'll come to me 
even if my mama done talked to her, you know. She 
wants me there, for anything. So that's how I 
reacted after I realized how she would react 
without me. I had to come home for some piece of 

(ID, 1000) 

This mother expressed pity for her daughter, because she was 
not available or near her when menarche arrived. She 
pointed out that young girls who are geographically 
separated from their mothers at menarche must turn to 
someone else, such as the grandmother, to console them. 
Consequentially, in this instance, since she was at a 
geographical distance, she felt obligated to return home to 
be near her early-maturing daughter for the balance of the 
menarcheal flow. Moreover, she indicated a feeling of guilt 
for not having been with her daughter at menarcheal onset. 
From this mother's perspective, in general, mothers prefer 
to be with their daughters at the time of the first 
menstrual flow. 

At Another Time 

Earlv-maturers' views on being older . Same -age girls 
may not be equal in physical growth (Tanner, 1962, 1981). 
Girls who are more advanced in development than same -age 
peers, menstruate at an earlier age (Herman -Giddens et al . , 
1997). An early developer feels different or out-of-phase 
with friends and peers (Bios, 1961; Caspi & Moffitt, 1991) . 
This 9 -year-old early-maturer explained why menarche should 
come at a later age: 

[Crying while speaking.] Nobody else has it in my 
school. All my friends don't have it. I think 
I'm different. . .1 think a person should start the 
period when they're older, like 15, cause I don't 
want it to come when I'm playing. I have to stop 
and change pads and wash myself. Its a lot of 
work and trouble. [Paused - a brief period of 
silence, but crying continued.] Someone may 
notice the pad or smell it when we are playing. I 
don't like the period when I'm playing. 

(ID, 9533) 

This early maturer touched on the topic of girls identifying 
with same -aged peers and friends by sharing like 
experiences. She brushed the issue of some young girls 
thinking they are different when they are the only one 
menstruating in their friendship group. Menarche is a 
biological proven that symbolizes a difference to peer group 
members who are not experiencing the menstrual event (Golub, 
1992) . She identified age 15 years as a good time for 
menarcheal onset. From her position, an older age girl of 
15 years engages in different interests and activities than 

a younger age girl of 9/10 years. Her thoughts are that 
older age girls can better manage the menstrual flow than 
younger age girls. 

Some early-maturer participants were sick with 
menarche. Girls who were sick and feeling badly, tapered 
their play routines. Some of the girls remained inside 
their homes for solitude. This 9 -year-old of 108 pounds 

A little girl don't need a period, cause it makes 
her sick and she can't play and go outside 
anymore. I wouldn't mind having it at 25 years 
old, cause then I would be grown and would know 
what to do. 

(ID, 7784) 

Another early-maturer, age 10 years and weighs 102 pounds, 
was in the study for 13 months. She stated that: 

Older, much older about 18 or 20... I could play 
and stuff. It kept me from playing, cause I was 
sick. I had to change the pads a lot. I felt so 

(ID, 1776) 

According to the young girl participants in this study, 
females of 18 years or older are considered to be adults or 
grown-ups. These young girls believed that grown-ups know 
how to care for themselves when they are menstruating. Also 
grown people can handle the sickness that comes along with 
menstruation better than a child of 9/10 years old. 
Besides, grown-ups are free to go outside when they are 
menstruating, but some little girls are not free to do. 

It is important that a person understand what is 
happening to their body as they move from one developmental 
stage in life to another. Menarche is unlike most 
developmental events in that it is discrete and may occur 
without noticeable warning. It can be argued that menarche 
is a pivotal event in a female's developmental life course. 
This 10-year-old early-maturer stated: 

I think a person should be older, 18. I don't 
really understand it. I don't really know why it 
happened to me right now. I don't know. I think 
I could understand it better if I was much older. 
I can't remember everything everybody said about 

(ID, 1000) 

Cognitively, older-age girls are able to process and 
understand information about the menstrual cycle better than 
early maturing girls (Chi & Koeske, 1983; Siegler, 1996). 
Most people tend to be more accepting of certain situations 
and events affecting their personal life if they have an 
understanding of what is going on. Several people including 
friends, relatives, teachers, and parents could be involved 
in educating young girls about the menstrual cycle (Swenson, 
Foster, & Asay, 1995) . Some early-maturers may feel 
bombarded by information from numerous sources and may not 
be able to process it for comprehension as rapidly as they 
receive it. Thus, the early-maturer participant in the 
above narrative addressed how she had difficulty remembering 
everything taught about menstruation at the time of onset. 

Menarche can appear at similar ages in female family- 
members (Chern, Gatewood, & Anderson, 1980) . If a young 
girl's mother and sister started at an early age, then she 
will also most likely start at an early age. Some girls, 
however, desire to be different from all other family female 
members. They wish to identify more with their friends 
relative to the time of menarcheal onset. This 10 -year-old 
from a middle- class nuclear family with an older sister 

Age 16, way up there is a good time to start. 
It'd be like everybody else (her friends) started. 
Everybody in the family started at age 11, I'm 10. 
I wanted to be the first one to start way, way up 
there. That way, mostly, plus then, you know, if 
I'm 16, maybe I would have changed some of my 
lifestyle and able to handle it better. 

(ID, 0201) 

For this participant, menarcheal onset at age 10 symbolized 
similarity with her female family members. Peer group 
acceptance and friendship are important to her as a 
schoolage girl. She expressed that girls who are different 
will most likely not be accepted into their friendship 
groups. Albeit, family is important to developing children 
(St. Jean & Feagin, 1998), but peer acceptance is critical 
for many schoolage children (Bios, 1962; Bronf enbrenner, 
1997) . 

Early-maturers' views on being vouncrer . Sick children 
are more likely to manifest behavioral regression to a phase 
lower than their chronological age (Comer & Poussaint, 1992; 

Cooper, DeHart, & Sronfe, 1996) . They desire and sometimes 
require attention and pampering, preferably, from their 
mothers. The menarcheal flow made several of the early- 
maturing participants sick. Two early-maturers of age 10 
had this to say about why menarche should come at an age 
earlier than 9 or 10. The first early-maturer stated: 

It should come earlier, about 5. A person could 
get more attention from the mother, cause the 
little girl is sick. She could be held and rocked 
by her mama. Her mother could do things for her. 
[Mother momentarily took a stiffened and 
breathless posture as if stunned by her daughter's 
remark. ] 

(ID, 5569) 
The second early-maturer stated: 

Probably 16. Shhhhhhhh, 16. No, no, no, 18. I 
don't know. I think really early, like 4 or 5 , 
for attention. I like to be pampered when I'm 
sick. Mama [treats me like a baby] and buys me 
stuff. Yeah, younger, Umm hmm. [Mother lowered 
her head while quietly sighing.] 

(ID, 2750) 

According to these participants, an early-maturing child of 
9/10 years of age is a little girl. They indicated that 
little girls require greater affection and attention from 
their mothers when they are sick. Mothers, on the other 
hand, may feel that a girl of 9/10 years old is too big or 
large for the mother to hold in her lap as she could easily 
do for a smaller girl, age 5 years. An early-maturer 
participant indicated that her mother feels sorry for her 
when she is sick and purchases gifts out of pity and in an 

effort to make her feel better. Both participants felt that 
menarche is certainly a symbol of sickness and mothers 
should treat little girls accordingly - take care of them. 

Mothers' views on being older . Mother participants 
agreed that early-maturing girls fall short when it comes to 
cognitively understanding menstruation to the level of 
feeling comfortable with its process. This 55 -year-old 
mother recognized the cognitive thinking of her daughter: 

She was not mentally ready. I don't think so, 
because she just said, she still only knows she 
bleeds and that's it. That's it. So, she is not 
mentally ready to know as to why she really is 
having her menses, or her first period. . .Even 
though she's started, I feel like she's still one 
of the little [children] around here. I basically 
see her as the same. She's still playing on the 
floor, riding her bicycle, romping and everything 
else with everybody else back there on the porch. 

(ID, 1844) 

Concretely, the menstrual flow means vaginal bleeding and 
this is how it was interpreted by this early-maturing girl. 
To bleed from a body orifice without understanding the "why" 
can be emotionally profound and devastating. This schoolage 
child's understanding of things is concrete; she views 
things to be the way that they are presented to her. The 
menstrual flow presented as bleeding and that is how she 
comprehended and acted upon it. As an early-maturer who is 
110 pounds, according to the mother, she is still a child 
with childlike behaviors. 

Another mother, age 33 years of middle-class 
socioeconomic status, made similar comments about her 9- 
year-old daughter of 108 pounds and 5 feet 3 inches tall: 

She is still a little girl. She doesn't know what 
this menses is all about. For 2 days it was on 
and she didn't say anything until we were going 
into Eckerd's. For 2 days, nothing. It was on a 
Wednesday afternoon, and I was getting out of the 
car and she said, "Mama, my period is on." I 
said, "What? When did it start." That's when I 
learned about it. She had been stuffing her 
panties with tissue for 2 days. She said she had 
to think about what it was, cause she really 
didn't know. She wasn't for sure about what it 
was. She is not ready for it. I just bought a 
Barbie for Christmas and she plays with it, her 
dolls. She may look older than 9, but her mind is 
still like a little girl's. This period was not 
something we expected at this early age. I wasn't 
prepared for it, because I wasn't expecting it 
this early. I thought we had three or four more 
years . 

(ID, 7784) 

This early-maturing girl was "slow" about informing her 
mother that she had started her menstrual flow because she 
had to think about what was happening to her. She needed 
time to process previously received information from various 
sources about menstruation. Therefore, it is not unusual 
for her to take a day or two before informing her mother 
about her menarcheal status. 

Most mothers are aware of the aches and pains 
associated with menstruating. Mother participants 
sympathized with daughters who experienced nausea, 
stomachache, backache, and muscle cramps. This 37 -year-old 
mother described how sick her 10 -year-old was as she 

explained why menarche should come at an age older than 9 or 
10 years: 

I was 14 when I started mine. And [she's] 10 when 
she started hers, and I think its just too young. 
The things you have to go through. Like, 
stomaches, backaches, cramps. She was sick. Sick 
and nauseated and stuff like that. I felt so 
sorry for her. She is a little girl and [she] is 
quiet and immature as compared to a lot of her 
classmates. She is the only child and is still 
very much a baby. 

(ID, 1000) 

This mother reported that menarche is not for young girls 
who are immature and still very much "babies." She 
indicated that more mature and older age girls can better 
handle the physical discomforts associated with 
menstruating. Accordingly, little girls should not have to 
endure stomaches, backaches, cramps, and nausea associated 
with menstruation. 
Sexual Sensuality 

Girls are sexual beings (Masters, Johnson, & Kolodney, 
1992; Vinovskis, 1988). The menstrual cycle is regulated by 
reproductive and sexual hormones (Delaney, Lupton, & Toth, 
1988; Guyton & Hill, 1996). These hormones trigger sexual 
urges and desires. Menarcheal onset, according to 
previously described statements from mother participants, 
symbolizes a young girl's sexual sensuality and desires for 
the companionship and affection of a young boy. 

A 35-year-old mother with a 10-year-old early-maturer 
described her thoughts and feelings about a female's sexual 

interest at a "certain time of the month" during the 
menstrual cycle: 

Very nervous at first. Very nervous, cause she's 
so young and menstruation, you know, you have 
certain feelings and desires with the hormones. 
At a certain time of the month, the hormones act 
on the body and desires are there. Ah, she is 
human and her body reacts to hormones just like 
any female. So I'm nervous and concerned about 
her and the possible desire or wish to be with a 

(ID, 9156) 

This mother's narrative indicates that sexual hormones act 
on all humans in a similar fashion. Mother participants are 
humans and they experience sexual urges and desires at a 
certain time of the month with their menstrual cycles. This 
sexual knowledge is frightening and made most mother 
participants nervous when they thought about it in reference 
to their early-maturing daughters of 9/10 years of age. 

Some parents expressed a sense of disbelief about their 
9/10 -year-old daughter being sexually sensual and 
reproductively capable. Regardless of their early-maturer • s 
chronological age, mental maturity, and body size, parent 
participants acknowledged her menarcheal status and its 
ramifications. A 29 -year-old mother described how concerned 
she was when she learned of her 10 -year-old daughter's 
menarcheal status: 

It is kind of frightening. Sometimes it frightens 
me. Sometimes I think about it. She is so young 
and she's not a very big girl for her age Her 
older sister started at 13; they're 5 years apart 


It bothered me when she started, but not like it 
is with her. I told her dad and he said, "What? 
She's too young." I told him apparently they're 
starting young nowadays. But like I said, my 
older girl was 13. We feel that we have another 
one to worry about when it comes to boys and 
pregnancy. Her dad said, "She's too little to 
have a baby." I told him girls are getting 
pregnant at that age if they see their monthly. 
So, he said, "Well, keep the boys away." 

(ID, 6837) 

It is normal for African American females to start 
menstruating as early as 8 years old (Herman -Giddens et al, 
1997) . Therefore, it is not unusual for African American 
girls to experience menarche at 9 and 10 years old. 
Nevertheless, some parents find it difficult to accept that 
a 78 pound 10 -year-old young girl is capable of 
menstruating. This mother reported how she found it to be 
frightening and that the child's father questioned its 
reality. Whatever some parents may feel, think, or believe, 
menarcheal onset symbolizes sexual sensuality and pregnancy 
possibilities to many of the participants in this study. 

The father in the above narrative communicated to the 
mother that boys must be kept at a distance from the newly 
menstruating young girl. Both girls and boys are sexual 
beings and must be supervised to prevent sexual intercourse 
and other sexual activities (Barone, 1995; Miller, 
Christopherson, & King, 1993; Orr, Breiter, & Ingersol, 
1991; Prendergast, 1993) . 

Some early-maturing girls may show sexual interest in 
boys prior to their menarche. This 27-year-old single 

mother described her concern about her 10 -year-old 
daughter's known interest in boys: 

It bothered me, bothered me a lot. I'm still 
thinking about what could happen. Once it hit me 
and knowing how she likes boys, I became very 
nervous. Her dad made a big fuss about a boy she 
was liking. I don't want her being with a boy. 
She could get pregnant and it is so many different 
diseases and things out there that they don't know 
how to treat or prevent. Sex is too dangerous 
nowadays. She is so fast and sneaky, she's slick. 
But when she started her period, I became worried 
about her having greater interest in boys. 

(ID, 6289) 

This mother's narrative points out that some young girls may 
show an increased sexual interest in boys with the onset of 
menarche. At menarche, according to the mother, she and the 
early maturer's father became concerned and expressed 
dissatisfaction with their daughters' sexual interest in 
boys. Sexual diseases are rampant (Masters, Johnson, & 
Kolodney, 1992; Zabin & Hayward, 1993). She identified 
sexual activities as being unsafe and that her daughter 
sneaks behind their backs to be with a boyfriend. Also she 
identified menarche as an indication that her early-maturer 
will have increasing sexual interest in boys. 

A parent participant was accepting of her daughter's 
menarcheal onset; she had no known sexual interest in boys. 
A few parents believed, for the most part, they could trust 
that their early-maturers would not show interest in sexual 
activities. Some early-maturer participants with boyfriends 
professed to their parents that they did not have a 

This 38-year-old middle-class mother described how 
concerned she became about her 10 -year -old' s menarcheal 
status when she learned about her interest in boys during 
this interview session: 

I wasn't worried, concerned, or anything until I 
just learned she got a boyfriend. See, I'm this 
way with my girls, I trust them. I see people 
being so strict that they won't let the children 
go anywhere. Her sister goes to movies, games, 
and other places without one of us tagging along. 
Now she needs one of us, cause she can't drive. 
But like I said, I trust my girls. But it upsets 
me when they lie. Just the other night her father 
was talking to them about boys, sex, and babies. 
They started laughing and said, "Mom what is dad 
talking about? We don't have boyfriends." Uh 
mmm. So right now, I'm a little upset and 
disappointed. She lied to me and her dad about 
the boyfriend issue. She talks so much and so 
fast, she tells on herself without realizing it. 
I will look into this boyfriend business and love 
letters . 

(ID, 0201) 

Children are insightful about parents' rules and 
restrictions. This mother's narrative indicates that young 
girls who are aware that boyfriends are forbidden, interact 
with parents as if they have no interest in boys when in 
reality they do. In other words, some young girls will lie 
to their parents about a boyfriend if they are not allowed 
to acknowledge that they have one or cannot date (Jaccard, 
Dittus, & Gordon, 1998) . 

Talkative- tell-all girls, as described by this mother, 
will unknowingly reveal that they do have a boyfriend when 
in a comfortable conversational setting. since this mother 

was made aware by her early-maturer that she does have a 
boyfriend, she became concerned about how the menstrual 
cycle will affect her child's sexual life. 

Early-maturers are more likely to engage in sexual 
activities and become pregnant at an earlier age than late- 
maturing girls (Jaccard, Dittus, & Gordon, 1998) . Little 
boys and girls, as intimate friends, will indulge in sexual 
activities if given the opportunity (Costa, Jessor, Donovan, 
& Fortenberry, 1995). A 55-year-old mother who adopted her 
four granddaughters had this to say about the menarche onset 
in her 10-year-old: 

I'm afraid that one day it could affect my 
retirement. It didn't bother me when I first 
learned she'd started, but the more I thought 
about it, I said, "Dang, what if she gets all 
wrapped up in that boy and have sex." I started 
thinking like that, you know. But right now, I'm 
not too concerned about her having sex. She had 
what I guess she called a boyfriend and he used to 
come over here a lot. Every time I looked up, he 
was here. I know what little boys and girls will 
do if they have the chance. But these are my 
granddaughters and I got four of them. So, I'm 
concerned about what if one of them get pregnant 
while still in school with no job and no husband 
That's how I reacted to her starting. I told [my 
husband] , I said, "Hey old man, we could be caught 
up in here raising great grandbabies. " We sure 
can. So, this is what I'm worried about. 

(ID, 1844) 

This narrative shows that grandparents raising an early- 
maturer as their own child are concerned about how the young 
girl's menarche might impact their impending retirement. 
This participant acknowledged that boyfriends and 

girlfriends do have sexual intercourse. If her early- 
maturer becomes pregnant as a young student, she would be 
forced to delay her retirement in order to have income to 
support an increased family size. 
Private Business 

Early-maturer participants described the onset of 
menarche as a secret and private matter. They indicated 
that it is a young girl's private business. A 10 -year-old 
who joyfully announced her menarcheal onset to her mother 
and father stated: 

No, no, you just don't tell. We live in a small 
compacted area, you know. The Black community is 
so small. You know how everybody knows 
everybody's business. There are somethings you 
just don't tell. Who must know that anyway? You 
tell this person and this person tells that person 
and before you know it, everybody knows all your 
business. And then the boys think you are ripe. 
I was told that when a girl sees her period that 
it means she is ready for sex. The boys at my 
school say that. I've heard other people say that 
too. Yes, people say that. I don't think people 
need to know. Just keep it quiet. 

(ID, 5569) 

This early-maturer reported that a small compacted community 
is a rumor mill and a young girl's personal life about 
menarcheal onset can travel quickly. She stressed that the 
general community does not need to know certain things about 
an individual's personal life. She pointed out that 
menarcheal onset symbolizes to young boys that a girl is 
sexually ripe and ready for intercourse. Most young girl 
participants do not wish to be gawked at by boys as sexual 

objects available for their gratification. According to 
this early maturer, it is best to keep an early-maturer ' s 
menstrual onset as a quiet and secret affair within her 

A 9 -year -old participant who took two days to inform 
her mother of her menarcheal status described how she felt 
about her mother broadcasting the onset of her menarche to 
people in the local community's beauty salon: 

My mama told the people at the beauty salon, but 
she hasn't told anybody else. I don't think it is 
anybody's business. It's a secret and it's my 
private business. Everybody don't have to know 
that I've started. It's my business. 

(ID, 7784) 

She stressed that there is no need for everybody to be 
informed that a young girl has started to menstruate. 
Although menarche was revealed to her mother, she expected 
her mother to keep it a secret. Once her mother informed 
everybody in the town's beauty salon about her menstrual 
onset, it was no longer a secret. Mothers are privileged 
family members; early-maturers will most likely self- 
disclose their menstrual status to mothers, but not the 
general community (Van Manen & Levering, 1996) . 
Confidentiality for this early-maturer was a sine qua non. 
Consistently, it is not unusual for some girls to go for 
years without revealing to their mothers, or anyone else, 
that they have started their menstrual flow. For some young 
girls who felt mothers would not keep their personal 

business in a private and secret way, they hesitated to 
divulge their menarcheal arrival. After all, according to 
the early-maturer participant's narrative, it is the young 
girl's personal business, which is private. 

Schoolage children have circles of friends. Early- 
maturing participants who shared secrets with their friends, 
fail to realize that their friends had other friends who 
told someone else about their secrets. A 10 -year-old 
participant described what happened when she shared her 
secret about her menarcheal onset with friends: 

Personally, I think it's wrong to tell. I told 
all my friends at school, cause I was happy to 
start. Everybody else had started but me. I was 
the last one to start. [Investigator asked: "All 
the girls at school in your class?"] Oh, just in 
my group. My friends and me. So, I told 
everybody. I mean all my girlfriends. I was so 
mad! The next day I learned they told some other 
people I don't like, and they were talking about 
me having my period. I was just sooooooo mad! 
[Frowned in anger.] One girl said, "You're on your 
period?" I [snappingly] said, "Who business is 
it?" I was mad! 

(ID, 2750) 

This 10 -year-old early-maturer summed up why she 
doesn't tell her business: 

It is nobody's business. I hear girls telling 
their business and then they get mad when I hear 
that their business is all over the streets. I 
don't tell my business. 

(ID, 6289) . 

These early-maturers reported that young girls become angry 
or upset when they learn a friend has revealed a secret and 

many people come to know the secret. Information revealed 
to several people cannot be considered a secret (Berardo, 
199 8; Van Manen & Levering, 1996) . Secrets are limited 
between two people and off limit to a mass of people, or 
more than three or four individuals (Smith, 1997) . These 
girls made it known that revealing a secret to several 
friends is no guarantee the "secret" will be contained. 

Menarcheal onset in early-maturing girls of 9/10 years 
has various meanings and emotional responses for parents and 
the young girls. This 45 -year-old mother with a 9 -year-old 
early-maturer stated: 

We didn't broadcast it or do any special ceremony. 
This is private. It is a private time for girls. 
Now, her sister called all her aunties and told 
them... She was sort of upset with [her sister]. 
She didn't like that being broadcasted to her 
aunties nor her grandmother. She said, "Why did 
she do that?" I said, "You know how flip your 
sister's mouth is." She didn't really want 
anybody to know. It was her private business. 
She had to listen to everybody tell her about the 
things her dad and I told her; all those things 
from so many different people. 

(ID, 1057) 

This mother reported that menarcheal onset is a private time 
for young girls. There is no need for broadcasting the 
occasion to grandparents, aunts, friends, and other 
relatives. Some young girls, according to this mother, 
prefer not to receive menstrual information from so many 
different people at its onset. Once several relatives and 
close friends learned about the early-maturer ' s menstrual 

status, she risked hearing different versions of advice from 
several people about the same subject, a private personal 
topic. For this reason, her older sister should not had 
divulged to anyone that she had started her menstrual cycle. 
Based on this mother's narrative, then, menarcheal onset in 
early-maturing girls should be treated by all family members 
as a secret and as private business. 

For most young girls and their parents, menarcheal 
onset was not only a private and secret matter, but was also 
an emotionally sensitive life-event. This 42 -year-old 
mother commented: 

We don't believe in that. Menstruation, you just 
don't broadcast, you know. That is something 
else, a 10 -year-old child being able to get 
pregnant. I don't know what is happening in this 
world today. Sometimes I think about it, that she 
is capable of getting pregnant at her young age 
and it is scary, scary. Nooooo, we haven't told 
anybody about this, and I don't think she wants 
anybody to know it anyway. [Child crying as she 
moved head from side to side for a no answer to 
indicate agreement with the mother that she does 
not want anybody to know of her menstrual status.] 

(ID, 4520) . 

Family beliefs about menarche were important when it came to 
whether or not they would let others know of the early- 
maturer's menarcheal status. The age of developing females 
at menarche is important (Bullough, 1996; Grief & Ulman, 
1982; Herman -Giddens et al . , 1997). Menarche is not only a 
biological event, it has social and psychological effects on 
how the child feels about herself (Blumer, 1969; Chadwick, 

1992; Doswell & Vandestienne, 1996), how others close to her 
perceive her to be (Hewitt, 1994) , and how she feels about 
the thoughts of others regarding her menstrual status (Hyde, 
1996; Lee & Sasser-Coen, 1996) . It is scary, according to 
the mother in the above narrative, to think that a child as 
young as 10 years old can reproduce her own child. Menarche 
in an early-maturer is private business and is not to be 

Regulating Sexual Behavior 
Mother participants were concerned about the sexual 
activities of early maturing girls. Common sexual behaviors 
for 9/10 -year-old boys and girls include genital self- 
stimulation, kissing, dating, light petting, observing and 
touching each others genitals, and dry humping (Bagley, 
1997; Goldman & Goldman, 1988). The peak period for 
"playing doctor" is around 9 and 10 years of age (Lamb & 
Coakley, 1993). The schoolage period of development, 8 to 
12 years old, is marked by increased peer contact (Cooper, & 
DeHart, & Sronfe, 1996) and experimental sexual interactions 
(Bagley, 1997) . Some children experiment with oral sex, but 
"only 2% to 3% engage in intercourse" (Gil & Johnson, 1993, 
p. 42) . The strategies used by parents to regulate young 
girls' sexual behaviors are described in this section as 
gender sexuality scripting, gender segregation, parental 
supervision, and good company. 

Gender Sexuality Scripting 

Participants discussed knowing that the onset of 
menarche accentuated the meaning of "being" for the female 
sex and gender. Scripting, a form of socialization about 
behavioral norms and rules (Kornblum, 1997) , was done by 
parent participants. Female-gender sexuality scripting 
(Simons & Gagnon, 1986) allowed early-maturers to receive 
guidance and instructions as menstruating females. Through 
gender sexuality scripting, parent participants were able to 
socialize their early-maturers about how to conduct 
themselves when interacting with young boys. A major aim of 
sexuality scripting for the parent participants was to teach 
the early-maturer how to avoid arousal of erotic urges and 
desires that could lead to inappropriate and regrettable 
sexual decisions. 

A 9 -year-old participant and her professional mother 
described sexual scripting. The early-maturer stated: 

Mom sat down with me and talked about the period. 
She said nobody can touch me down there except me, 
because if someone touched me, a boy touched me 
down there, I might have a baby... Daddy knows. I 
told him after I talked with mom. [Investigator 
asked: "What did he say?"] He didn't say 
anything. He may have said something to mom, 
cause I heard him tell mom that I couldn't run 
around nude and I can't take baths with Trnv 
brother] . 

(ID, 9533) 

Sexual education for this early-maturing girl was mostly 
done by her mother. Her mother informed her about what 

happens when there is erotic touching of a sensual body- 
area, such as the pubic region by young boys. Further, 
menstruation was an embarrassing topic for this early- 
maturer's father by evident of his silence when she informed 
him of her menstrual status. Previous statements made by 
other mothers and early-maturers in the study showed fathers 
understood the symbolic sexual and reproductive meanings of 
menarcheal onset in their early-maturing daughters. This 
narrative shows that this father was more comfortable 
talking to the mother about what he perceived to be 
acceptable feminine behaviors for their sexually maturing 
young daughter. His silence indicated discomfort with 
talking about the female's menstrual process with his 
daughter. Nevertheless, from the outset this young girl was 
socialized that all signs of menstruation must be kept 
hidden from view, especially in relation to the male. 

The mother of the 9 -year-old participant in the most 
previous narrative stated: 

Things that I was taught, and I'll do those type 
of things as we go about our day to day activity. 
I don't think we have special sessions set aside" 
just to teach this, but in our day to day 
activity, I'm incorporating more of the ladylike 
type of things that she does. Her daddy's now 
caught in the same thing as I noticed just 
yesterday. I've been getting on [her] about. 
Around here, we'll (the children) just walk around 
in the nude, if they're going between baths, and 
we'll let them take all their stuff off in the 
laundry room and just run across the house to get 
in the bathtub. But about a month or a year ago 
about a year, I've been leading up to this time of 
telling her you have to be very particular of your 
body, very particular. What we see, other folks 


don't supposed to see. Again, get the towel or 
put clothes on... Since we've gone through a 
cycle, we had to limit her activities of bathing 
with [her younger -age brother] and running around 
with no clothes on. 

(ID, 9533) 

This mother discussed how everyday routine social 
interaction allows a parent to script an early-maturer about 
ladylike behaviors. She pointed out that female- gender 
sexual scripting is not necessarily planned and that it may 
occur without a parent's or child's conscious awareness; 
the messages are often time transmitted in subtle ways (St. 
Jean & Feagin, 1998) . 

This 40 -year-old professional mother continued with her 
conversation on gender sexuality scripting relative to 

She is very comfortable with me, relaxed with me 
as compared to [her dad] . She gets relaxed with 
him too, but she takes him more serious. I 
usually have to say something twice or tell her to 
do something twice, and sometime more than twice, 
whereas her dad only has to say it once and off 
she goes running. Like the other day, she 
presented herself before him in the nude and [he] 
told her, "Didn't your mother tell you not to run 
around without any clothes on." I don't know how 
many times I said that, and he comes along and 
does it once and she stops... He was brought up in 
an open or less restricting home environment than 
I was . We didn ' t run around the house nude in my 
home. [His mother] was the only female in the 
house, and I think the only one who wore clothes 
[He] has four brothers and they all ran around the 
house practically nude. My sisters-in-law 
complain about it all the time. I just gave up 
I used to run behind [these children] with clothes 
in my hand yelling, "Ya'll need to put clothes 
on." [Her dad] would say, "Leave 'em alone. Let 
'em be free. Clothes are restricting." Those 


type of things. So, I said, "What the heck." 
Today he walks around here with nothing on but 
briefs. At one point in this family, everybody 
was nude, including me. I told him I wasn't 
brought up like that and that [the children] were 
getting older and I didn't want them to see me or 
him without any clothes. So he eventually started 
wearing briefs. Now that I think about it, [the 
females in this house] wear clothes and [the 
males] are without. It's kind of like his home 
environment with his mother, father, and brothers. 
I hadn't connected [her] bathing with [her 
younger -age brother] and not wearing clothes 
around the house to the period, but he did. I 
just grew accustomed to [the children] being nude 
and [her dad] wearing nothing but briefs. 

(ID, 9533) 

These parents allowed their early-maturer to bath with her 
opposite- sex sibling and to practice home-nudity prior to 
menarche. Once menarche appeared, however, they sexually 
scripted her that such behaviors were now forbidden. The 
sexual parts of her body that were allowed to be freely 
exposed within the home setting had to be covered for 
privacy. Further, the way in which nudity at menarche is 
treated in this home will mostly likely influence the early- 
maturer ' s developing attitude toward sexuality. 

Most parents, especially fathers, are uncomfortable 
with nudity in early-maturing daughters. Early-maturers who 
menstruate have pubic hair, developed breasts, and sensual 
body curving of the waist and hips (Guyton & Hill, 1996; 
Tanner, 1981). By prohibiting home-nudity at menarche, this 
father demonstrated his discomfort with his menstruating 
daughter being nude in his presence. 

As the dominant family figure, this father realized he 
was faced with the reality of breaking his silence about 
home -nudity since his menarcheal daughter was not adhering 
to rules laid down by her mother. The mother in this 
situation realized that the early-maturer obeys her father 
sooner than she does her. Thus, she required the help and 
support of the early-maturer ' s father to enforce gender 
sexual rules. 
Cross -Sex Segregation 

Schoolage girls and boys form friendly relationships 
that often times develop into sexual sensual activities 
(Prendergast, 1993). Parent participants acknowledged that 
boys and girls are sexual beings and will take part in 
sexual activities, given the opportunity. At menarcheal 
onset, parent participants were particularly concerned about 
existing boyfriend/girlfriend relationships. With knowledge 
on hand about sexual urges to the menstrual cycle, parent 
participants resolved cross -sex relationships at the time of 
young girls' menarche. 

The following 10 -year-old early-maturer had this to say 
to a series of questions about her boyfriend: 

My boyfriend is 10, ah, 11 years old. Daddy got 
rid of him, he ran him off... I see him at school 
but not at home anymore... Daddy said he is bad 
news and that he can't come around me anymore. 

(ID, 5483) 

This early-maturer responded, "Unh Unh" for a no answer 
before the mother could complete her statement regarding her 

beliefs about the daughter's sexual activities or lack of 
them. However, her 26 -year-old single-parent mother stated: 

You hear what she say. You would say yes she done 
it (sexual intercourse) if you read the love 
letters. We think she has. Urn hm. I think so... 
We have talked to her about boyfriends and stuff, 
but I tell her to keep her mind on her education, 
and like I was telling her, there is going to be 
plenty of time for boys and boyfriends, because we 
been, she has been sneaking and writing love 
letters and stuff like that. She was sneaking 
around with the boyfriend at her age. Ten years 
old is mighty young to be having sex and giving 
birth to a baby. But when they start [to 
menstruate] you have to take that into 
consideration that it is a possibility. Now, [her 
father] used to be tight buddies with [this boy's 
dad] . They were out there in the streets like 
wild fools, going from one woman to the other and 
now all of a sudden they both act like they never 
did anything wrong. I say he knows the stock this 
boy comes from and he doesn't want him fooling 
around with [our daughter] . 

(ID, 5483) 

The focus of this narrative is that young girls' 
relationships with boys must be considered in context with 
the onset of their menarche and the possibility of 
pregnancy. This mother identified love letters as evidence 
that her early-maturer was engaging in sexual intercourse 
with a male-friend. Some young boys, like their fathers, 
have inflated sexual drives. Fathers who were known 
womanizers are most likely aware of how young menstruating 
girls can easily be taken advantage of sexually by some 
males. Cross -sex segregation, then, was used by these 
parents to end what they believed to be a sexually active 
boyfriend/girlfriend relationship . 

Another 10 -year -old early-maturer who is 5 feet 4 
inches tall and weighs 107 pounds described a love letter 
she received from a boyfriend who wanted to have sexual 
intercourse. She also revealed in her rapid style of 
speaking what happened to an older age friend who had sexual 
intercourse. She commented: 

He (7 -year-old brother) found a letter. And I, 
you know, crossed through all the love and 
everything, all those little words. He does not 
have any words like sex. He knows that I don't 
play that. He knows that. Other boyfriends, 
like, "When are we going to lay down on the bed 
together?" Had to cut that off. I don't like 
that. We cut that conversation right there, you 
know. All my friends come, well I do have some 
friends who are like coming to school, bragged 
about it, went home and did it again, called me 
about it, told me about it. [Investigator asked, 
"You mean that they...?] Uh huh, (whispering) 
sexual intercourse. And you know I tell them, 
"You better stop." Well one friend, she had it 
three times already. She'd better stop. She 
moved over to Louisiana. No, I think it was 
Alabama. She was 14. She moved to Louisiana with 
the boy, yeah. The boy was like 19, cause he's 
going to college out there. Well it was Louisiana 
or Alabama. She moved up there. She had a little 
baby boy. So, you know, don't play that. I told 
her she'd better stop. 

(ID, 0201) 

This narrative shows that young girls who interact with 
boys, especially older ones, interested in engaging in 
sexual intercourse will most likely succumb to their 
continued pleas. The narrative also show that boys tend to 
use love-letter writing as an avenue to inform girls of 
their sexual desires. Prior to this interview session, her 
mother was not aware that she was "dating" and receiving 

love letters from boys interested in sexual intercourse. In 
this situation, the early-maturer decided that cross -sex 
segregation from a sexually persuasive young boy is 
necessary to prevent pregnancy. 

Later in the interview, the same rapid- speaking 10- 
year-old was encouraged through questioning to continue with 
her conversation about love letters and boyfriends. She had 
this to say about her own older-age boyfriend: 

The one I had a crush on, we are going out. [Going 
out means talking on the phone, writing love 
letters to each other, and seeing each other at 
various sport activities and community functions.] 
But he does not interfere in this [her period] . 
He's in the 9th grade. That don't bother me or 
anything. [She's not bothered about him being in 
the 9th grade while she is in the 5th grade.] But 
the letters, I don't like the letters. He tells 
me how his school is over there you know. Talking 
to him on the telephone. I'm gonna still see him. 
I've only seen him, how many times? Three times, 
cause he's in football. But he did write a nice 
letter to me, telling me how everything is, so he 
can [Instant brief moment of silence as mother 
looked at daughter and frowned in puzzlement.] 
Like, yeah, right. That's who he is and 
everything. But then if my dad finds him, he's 
gonna hunt him down like a dog! 

(ID, 0201) 

Sometimes parents are the last to know that their early- 
maturer is first of all "dating" and secondly that the young 
boy is years beyond their daughter's age. Many early- 
maturers look older than their chronological age (Herman - 
Giddens et al . , 1997) and are attractive to older-age boys. 
Parents do not approve of early-maturers "dating" or being 
sexually wooed by older aged boys (Jaccard, Dittus, & 

Gordon, 1998) . This early -maturer in the above narrative 
concealed a boyfriend relationship from her parents. In 
most situations, parents will end the boyfriend/girlfriend 
relationship once it is discovered (Jaccard, Dittus, & 
Gordon, 1998; Lamb & Coakley, 1993) . 

Some early-maturer participants professed unf amiliarity 
with the act of sexual intercourse. However, their parents 
resolved known boyfriend/girlfriend relationships even when 
an early-maturer professed ignorance about sexual 
intercourse. The following conversation with a 10-year-old 
early-maturer and her mother demonstrated the child's 
knowledge deficit about the meaning of sexual intercourse. 

CHILD: They (parents) told me I couldn't have a 
boyfriend. We weren't doing nothing but playing. 

INVESTIGATOR: Did you have sex? 

CHILD: No, we didn't have sex. 

INVESTIGATOR: You like him? 

CHILD: Yes'm, I like him, but they won't let him 
come play with me anymore. They say we might do 
something, so they ran him away. 

INVESTIGATOR: Do you know what sex is? 

MOTHER: She should know. It's enough on 
television, but she may not. We hadn't really 
told her, but they can put things [together] from 
what other people. (Abruptly ended sentence and 
turned to ask daughter.) What do you think sex 

CHILD: Kissing a boy. Hugging. 
INVESTIGATOR: Anything else? 


MOTHER: What about him touching your private part 
where you were bleeding. 

CHILD: (Frowns in puzzlement). That ain't his 
business. He's not supposed to be doing that. 

MOTHER: What did you think we were afraid of you 
and that boy doing? 

CHILD: Kissing. 

MOTHER: Where did you learn about the kissing? 

CHILD: (Silence. No answer.) 

MOTHER: We'll talk about sex later. I know she 
doesn't know what it is. Sometimes I think [she] 
is more of a baby than [her youngest sister] , 
cause she plays so much and she loves play. She 
can play all day if we let her. 

(ID, 1844) 

This mother indicated that few young girls of 9/10 years old 
in present day society are without an opportunity to know 
the meaning of sex and intercourse. There are many ways a 
young girl can learn about sex, which includes friends, 
television, and family members. However, this early-maturer 
is narrowly focused on play activities and seemed slow about 
processing information relative to sexual intercourse. 
Mother participants know that girls and boys who keep on 
kissing will soon learn the act of sexual intercourse. 
Menarcheal onset prompted this parent to initiate cross -sex 
segregation in order to keep kissing from progressing into 
sexual intercourse. 
Parental Supervision 

Young girls' sexual interest and behavior can be 
regulated under the supervision of their parents. A 
combination of several measures can be used by parents to 

supervise an early-maturer ' s sexual behavior. A 33 -year-old 
mother described how parental supervision keeps her 10 -year- 
old early-maturer from having excess time to think about or 
participate in a boyfriend/girlfriend relationship: 

They are so involved in so many things. I don't 
think they give boys much thought along that line 
[sexual interest] . They don't have much time to 
think about boys around this house. They are busy 
and they keep us running from one end of the 
county to the other. One night I was at the 
School Board with her sister and [her dad] was at 
the Methodist church with her. They're always 
doing something, always... [Mother continues] 
She's too busy for that. All the activities and 
programs with school, church, Girl Scouts, and the 
community keep her busy. They (her daughters) 
both are gifted and talented and someone is always 
calling for one of them to speak, sing, or do 
something. We (she and her husband) have to make 
an appointment to be alone with each other, 
because the girls keep us so busy with their 
activities . 

(ID, 5569) 

This narrative points out that young girls who are involved 
in school and community related activities under the 
supervision of their parents will most likely not have the 
time for an intimate relationship with the opposite- sex. 
This mother suggested parents' presence at various functions 
with an early-maturing girl allow supervision of activities 
and interests that will most likely deter formation of 
boyfriend/girlfriend sexual relationships. 

A 33 -year -old mother explained why her 9 -year -old 
daughter is not allowed to go outside the house without 
parent supervision. The mother stated: 


She is a good girl, but she can't go out anymore 
(outside of the house to play without parent 
supervision) . We have to watch her closely when 
she is not in school. [Investigator asked, "Why 
do you feel you have to watch her so closely?] 
There was a boy who came to our house and asked us 
if he could court our daughter. I don't think he 
realized that she was much younger than what he 
thought. She looks like a teenager, but she's 
only 9 years old. She's tall and breasted, you 
know. So, we told him NO! No, he could not court 
our child. We told him she was a baby, just 9 
years old. He was surprised to learn that she was 
so young. But I found out from my younger 
daughter that she had been meeting him at the 
fence over there on the other side of the house to 
talk. You see, I didn't know that. Anyway, we 
put a stop to it and we told him that if he 
bothered our daughter again, we would call the 
cops. Yes, yes, she is interested in boys. We 
know this. 

(ID, 7784) 

This mother recognized that her early-maturing daughter has 
physical features similar to an older age girl of teen 
years. An older age boy tried to establish an intimate 
relationship with this early-maturer without realizing her 
younger age of 9 years. The mother learned that her 
daughter encouraged the development of an intimate 
relationship with the older age male by failing to reveal 
her true age. As knowledge of the courting process reached 
this early-maturer -s parents, only then did the older age 
boy come to know the actual age of this early-maturer who 
physically appeared to be of teen years. 

For the most part, parent participants know that some 
girls will sexually tease and flirt with boys. Some early- 
maturers may enjoy the sexual attention and pleasures 

obtained from young boys. A 27 -year-old single mother 
described the sexual practices of her 10 -year-old early- 
matured daughter that required increased parental 

She is so fast (flirts with boys) . I have to keep 
a close eye on her. She had a boyfriend. She is 
not supposed to see him, but you know how these 
girls are nowadays. If she goes to the 
[neighborhood] store, I tell her to come right 
back home. I try to keep a close eye on her, but 
she is so fast... Her dad got rid of her boyfriend 
cause he was eating her [Investigator asked, "Oral 
sex?"]. Yeah, that's right, sure was. You see 
how she had you believing she didn't have sex. 
She sure was. But we found out about it. Yeah, 
sure was. [Her dad] threatened her. [She] is 
sneaky, she lies, and she likes boys (Daughter 
lowered her head as mother continued to speak) . 
She is attractive and I like to keep her pretty 
with pretty things, but she be after those boys 
too. She just started that running away from 
them, cause she's afraid of [her dad]. She 
doesn't need a boyfriend. She is a 10 -year-old 
child in elementary school. She doesn't need a 

(ID, 6289) 

This mother participant spoke about placing a limit on the 
time it takes for her sexually active early-maturer to 
complete errands away from home. Keeping- a -close -eye on 
this early-maturer allowed the mother to halt known sexual 
activities. As a 10 -year-old elementary schoolage child, 
according to the mother, she does not need a boyfriend. 
Supervision of this sexually active early-maturer required 
her mother to be astute to the crafty behaviors she uses to 
get close to her male sex partner. 

Parent participants felt that the menarcheal girl 
should stay in proximity to the mother. That is, if the 
mother is at home, then the early-maturer should also be 
home. This 35-year-old mother described the increased 
supervision placed on her 10 -year-old daughter with the 
onset of menstruation: 

We've always been strict but I think her dad has 
gotten more stricter than me. I trust her to a 
certain extent, but her father, he's more stricter 
cause he always say, "[She] needs to be home. She 
doesn't need to be anywhere without you, because 
she can get pregnant. Boys can persuade you." 
That's what he says, so, he prefers her to be, if 
she's somewhere, I should be with her. 

(ID, 2750) 

This mother described the father's knowledge about how boys 
can influence girls into sexual situations that may lead to 
pregnancy. According to this mother, the father felt that 
when young girls start menstruating, they should be closely 
supervised by their mothers. This father expected their 
early-maturing daughter to be wherever the mother was, 
preferably at home. The increased maternal supervision 
placed greater restriction on their child's activities 
outside the home environment. The goal is to limit contact 
with young boys who may entice their daughter into sexually 
compromising situations. 

Persistence is a common tactic used by some young boys 
who enjoy the company of a particular early-maturer. This 
29 -year -old mother described how she supervised and 

monitored phone calls from a persistent young boy desiring 
courtship with her 10-year-old daughter: 

I just seen one [boy] be interested in her a lot. 
He calls every night. Every night, 3 and 4 times 
a night. I have to make her get [off the phone] . 
I don't want to be hateful and mean to him. But I 
tell her to get off the phone, because she has to 
do her homework and chores. I tell him that she 
has to wash dishes. I say, "Well, she's washing 
dishes." The next 10 minutes he'll call back. I 
hate to be ugly. I try to tell him that she's 
doing work and next 15 minutes he'll call her 
right back. [Investigator asked, "How old is 
he?"] He's the same age, 10 years. Both are in 
the elementary school over there. He's a 
persistent little fellow. 

(ID, 6837) 

In response to a chain of questions about the young boy 
who is persistent in calling her, the early-maturer stated: 

Yes'm, I like him... We talk at school and on the 
phone... We just play, at school. I play with 
other boys, but I like him... Mama told me what 
sex is and she says we can't do that, cause we are 
children... Yes'm I do like him... He's nice and 
funny (smiles). I like him a lot... Yes'm I think 
of him as my boyfriend [Mother sighed in 
hopelessness . ] 

(ID, 6837) 

These two narratives show that young boys and girls who have 
established a boyfriend/girlfriend relationship may require 
parental supervision for regulating their sexual behaviors. 
The mother participant realized that boyfriends and 
girlfriends can spend hours on the phone talking if parents 
allow them. Thus, this mother supervised the frequency and 
the time-period of phone conversations. She expressed 

concerns that frequent and lengthy phone conversations with 
a boyfriend could keep her early-maturer from completing her 
chores, homework, and other important tasks. Also, the 
social time girls devote to phone conversations encourages a 
greater sense of sensual warmth and closeness with 
boyfriends. This type of sensual interaction can be 
curtailed with parental supervision of phone calls. 
Good Company 

Parent participants were concerned about their early- 
maturer 1 s company of friends. Some sexually active friends 
were not shy about revealing their sexual interests to some 
of the early-maturer participants in this study. Parent 
participants were concerned that friends would try to 
encourage their newly menstruating daughters to be more like 
them by engaging in sexual activities. A conversation with 
a middle-class 10-year-old and her 35-year-old mother 
described this parental concern: 

CHILD: My mom, she thinks that they (friends) are 
going to grab me in and have sexual intercourse 
with a guy. 

INVESTIGATOR: Are your friends having sexual 

CHILD: Um hmm. Most of them have sexual 
intercourse. Everybody knows it. 

MOTHER: You know for sure? 

CHILD: I know for sure. Yes, I know for sure. 

INVESTIGATOR: Are you into sex? 

CHILD: I'm not into sex, but they are. 


MOTHER: How do you know? 

CHILD: They talk about it and the boys that they 
have it with. 

INVESTIGATOR: Where do they have it? 

CHILD: They do it at school in the bathroom and 
on the bus. Sometimes they do it at home when 
their parents are not paying too much attention to 
them. That's what they tell me. 

MOTHER: Friends are very powerful when it comes 
to that (sex) . They want to be like their friends 
and be accepted. They don't want to lose their 
friends. A mother has an intuition to whose, you 
know, what type of person a girl is. It's hard to 
tell, you know, what type of girls, you know. You 
know your child and then you look at their 
friends. I told her, it seems like a difference 
in social class and home environment. But they 
are her friends. Now she is not easily persuaded. 
Like I said, [her dad] is concerned about the 
company of friends she has, and I am too. [She] 
knows how we feel about her friends. Ah, she 
seems to be sure that they are having sex with 
boys even at their young age. I have to tell [her 
dad] what she just said, cause he's strict and 
everything. He doesn't like secrets, no secrets. 
But I am concerned about peer pressure. 

(ID, 2750) 

This narrative shows that children take part in sexual 
activities at school, in automobiles, and at home. It 
appears, according to the early-maturer in this narrative, 
that friends tell other friends who their sexual partners 
are and where they are having sex. The mother participant 
expressed concern about friends sharing similar interests 
and activities. The mother emphasized that seldom will 
friends continue interaction with a person unlike 
themselves. Regardless of peer-pressure, however, this 
mother participant felt that her daughter is strong-minded 

and not easily persuaded. The mother discussed knowing that 
children from different home environments and socioeconomic 
classes tend to show a difference in sexual behaviors and 
other childhood interests. She and her husband focus on 
keeping each other informed about what goes on in the lives 
of their children to avoid surprises and secrets. 

Some parent participants felt that they could trust 
their early menarcheal age daughter would follow taught 
rules and standards about acceptable conduct. Some 
participants believed that it is impossible for parents to 
be with an early-maturer every day of the week, 24 hours in 
a day. This 3 8 -year -old middle -class mother who learned 
about her daughter's interest in the opposite sex during the 
study commented: 

First of all there are several things I was in the 
dark about. I don't know about friends having sex 
and a baby. And I just learned about a boyfriend 
who is in high school. My thing is if you're 
talking about it with friends, you'll start 
thinking about doing it. People can influence 
you. Also, we are not strict parents. We believe 
you have to trust them, you can't keep them 
barricaded in the house. You got to have trust. 
You have to trust your children, because you don't 
be with them 24-7. All you can do is talk to 
them. Hiding them away is not going to stop 
them. . . She knows that we do not want her having 
sex and no boyfriends. I've learned some things 
tonight from her talking here that she hadn't told 

(ID, 0201) 

This young girl knew the rules laid down by her parents 
about sex, babies, and boys. However, she manipulated the 

rules made by her strict parents who professed to be lenient 
and tolerant. But the mother indicated that she has non- 
strict rules and expressed disappointment with her early- 
maturer once she learned about an older age boyfriend and 
about an older age girlfriend who had given birth. 

Managing Menstrual Flow 
The menstrual flow involves vaginal blood flow and 
physical discomfort. Some newly menstruating young girls of 
9/10 years old are unfamiliar with measures used to manage 
the menstrual flow and effective measures needed to relieve 
physical discomfort. This section presents the significance 
of the mothers' attitudes and support for young girls at 
menarche. It also highlights measures used by participants 
for comfort, hygiene, and future cycle -preparation. 
Mother's Significance 

What the young girl participants learned about 
sexuality and menstruation within their families came from 
their mothers. Mother participants were charged with the 
primary responsibility of finding ways to help their 
daughters cope with and adapt to "womanly" changes. The 
significance of the mother was highlighted by a 10 -year-old 
early-maturer : 

Daddy is quiet, just really quiet, doesn't say 
much. He's a man, so he can't talk about a girl 
having a period. That's why mama had to talk to 
me. You see a man can't have a period, so girls 
need mothers. 

(ID, 5569) 


This narrative accentuates the fact that physiologically 
both the mothers and the young girls are of the female sex 
and both are capable of menstruating. Fathers, on the hand, 
are of the male sex and are not physiologically equipped to 
menstruate. As a result, this early-maturer felt that 
fathers cannot realistically identify with young girls' 
life -lived menarcheal experience. She expressed that young 
menarcheal girls need the help of their mothers for an 
understanding of the menstrual process and for guidance with 
appropriate hygienic and comfort measures . 

A mother contrasted the mother's and father's 
significance in the following manner: 

Now, we both talked to her, me and her dad. He 
talked more about boys, sex, and pregnancy. I 
talked about that too, but I had to tell her how 
to take care of herself. The pads, baths, 
changing, and those things. But we both talked to 
her. I do think a young girl needs her mother, or 
a mother-figure, someone who can identify with 
what she is really experiencing or going through. 
I think the mother is important in that way. 

(ID, 2750) 

Being unfamiliar with the menstrual flow and its management, 
according to this mother, fathers fall short of having life- 
lived experiences that could be used to guide young girls at 
menarche. Recall that some participants recognized that 
fathers are familiar with the erotic wishes and desires of 
young boys for girls who are menarcheal matured. In this 
way, according to participants, fathers can be useful by 
talking to early-maturers about how to conduct themselves in 

situations with young boys who perceive them as sexual 
objects for pleasure fulfillment. 

Mother participants are accustomed to supplies and 
products required to manage the monthly menstrual flow. 
Participants communicated that first -time menstruating 
females can benefit from their mothers' knowledge and years 
of direct experience with the various products, supplies, 
and comfort measures. Young girl participants turned to 
their mothers, not fathers, at menarche for instructions in 
menstrual care and comfort. 

When some of the young girl participants were happy and 
excited about their menarcheal arrival, they announced the 
event to both parents at the same time. One father 
recognized his limitations about the menstrual process and 
management and readily placed the joyful occasion in the 
mothers' hands. This mother stated: 

She came to our bedroom door yelling, "Mama, 
daddy, my period started." Her father said! "You 
can handle that one." [Laughter from mother.] 

(ID, 5569) 

Some early-maturers are not as fortunate as girls who 
have a mother living with them at menarcheal onset. A 9- 
year-old participant commented on how fortunate she was to 
have her mother near her once her menstrual flow started: 

I told my best friend. She doesn't have a mom 
(died of brain tumor) . she lives with her dad I 
think you need a mom to talk about the period 
I'm glad I have my mom and that she lives with me 
cause my mom helped me through this. I feel more' 


comfortable with mom. I feel comfortable with dad 
too, but more comfortable with mom about the 

(ID, 9533) 

This participant talked about a young developing girl who 
lives with her father without the presence of a female (or 
mother) in the home environment. She indicated that girls 
need their mothers at menarche even if they feel comfortable 
with their fathers. She showed sympathy for girls who will 
not have a mother at menarcheal onset to help them through 
the process. 

Participants voiced that menstruation is an 
embarrassing conversation for most men. They expressed that 
fathers feel that mothers are to help an early-maturer in 
difficult menstrual situations. This 10-year-old early- 
maturer described her father's response when he noticed her 
clothing was soiled with menstrual blood: 

Mama told me everything. [Mother asked, "Are you 
crying? Hold your head up and look at her."] 
Daddy didn't say anything. One day he said, "Go 
to your mama and tell her to fix you up." it came 
through my pants. He doesn't like to talk about 
it. I heard him say that to mama. We can't talk 
about it around him. 

(ID, 1844) 

Some fathers prefer that conversations about menstruation be 
limited within the female gender. They simply do not wish 
to hear about it, and this position is made known to an 
early-maturer' s mother as done by the participant in this 

narrative. This early-maturer ' s father directed her to seek 
her mother's help for control of the menstrual fluid. 

The mother of the above 10 -year-old early-maturer 
commented on her experience at menarche. She stated: 

Like I said, her dad didn't want to hear about it. 
He told me to handle it. I remember when I 
started, my aunt told my uncle, "Well, we got a 
little lady in the house." I guess he just knew 
what it was. That was it. He didn't really talk 
to me about it. It was all my aunt. She was the 
one who did all the trying to tell me what was 
what. Like I said, she told me that kind of 
information. I didn't know what she was talking 
about. I had forgotten. I was still playing at 
that age. I didn't think about that type of stuff 
any more. But [her dad] is no help. Like I said, 
I plan to remind her of it and teach her how to be 
responsible for it, cause [she] doesn't have 
nothing on her mind but playing. She is still in 
that play stage like I was when I started. That's 
all she wants to do, play. 

(ID, 1844) 

Another mother honed in on fathers who offered little or no 
help for young girls becoming little ladies with menarcheal 
onset. This mother also addressed the issue of early- 
maturers at the play- stage when many are seldom thinking 
about menstruation. Girl participants with play on their 
minds, according to this mother, must be reminded about 
menstruation and how to take care of themselves. 

Some mother participants believed it is significant to 
be present with their daughters at the time of menarcheal 
onset. It was disturbing to mother participants if they 
missed out on the opportunity to share the discovery of the 

initial menstrual flow with their daughters. This single 
mother with one daughter stated: 

I was up the road. I wasn't here with her. I was 
a little upset about not being here. It happened 
on a holiday, the 4th of July. I felt like I 
should had been here with her, cause I feel like 
I'm the mama. I should had been here, and that's 
the most, I'll never experience that again. Which 
I haven't because I wasn't here. Seem like I 
should had been here and given her [the] first 
pad. And, she come to me and say, "Mama I see my 
cycle." You know what I'm saying? 

(ID, 1000) 

The daughter of the above mother commented on her fear 
over not having her mother present during menarcheal 
arrival : 

At first I didn't know what it was. My grandma 
and my mama's friends told me what it was. They 
told me what to do, but I wanted my mama cause I 
was scared. 

(ID, 1000) 

Another mother separated from her daughter, but was 
expecting the soon arrival of menarche stated: 

She spent the summer with her grandparents in 
Texas. We talked on the phone about it every day. 
She called every day. She was scared it was going 
to come on and she would not be with me [Child's 
crying became louder.] 

(ID, 9533) 

The early-maturer participants indicated that children feel 
safe in the presence of their mothers when faced with an 
unfamiliar event. Their grandparents and mothers' friends 

do not replace the comfort and sense of security offered by 
their mothers during a stressful and anxiety producing life 
situation, such as the onset of menarche. 

Mother participants readily detected their child's fear 
and were able to offer words of comfort and reassurance at 
the right moments. This 10 -year-old illuminated how her 
mother helped to alleviate her worries about menarche. She 

The stuff in school really helped. My fourth 
grade teacher and my mom told me a lot of 
things... When it started, I went to my mama and I 
said, "Mom, my period started." She said, 
"Alright." It was in the morning and she was 
still in bed. She talked to me about it when she 
got up - told me what to do. She said, "Don't be 
worried, it'll be alright and make sure you wrap 
those pads and put them in the trash." She told 
me a lot. 

(ID, 0201) 

This young girl immediately informed her mother once the 
menstrual flow started. She recognized that her mother knew 
what to do and gave her information and specific directions 
about menstrual management. With a working-stock-of - 
knowledge securely received from her mother, her fears and 
concerns were alleviated. 
Comforting Measures 

Participants described the physical discomforts 
associated with their menstrual flow. The young girl 
participants complained about the odor associated with the 
blood, abdominal and leg cramps, headache and backache, and 
nausea. Mother participants directed young girls in 

measures to relieve the discomforts that accompanied their 
menstrual flow. The mother of a 10 -year-old early-maturer 

I had to talk to her; tell her how to keep herself 
and had to comfort her, cause she doesn't take 
pills. I had to kind of tell her how to use the 
pad. The first day, the second day she was on, 
she used like 5 pads at one time. And, what? 
[Interrupted by daughter. "It was two."]. No it 
wasn't, cause I was working that day. It was on a 
Sunday, cause I remember it, your second day. 
When it happened, I went and bought her some pads. 
[Her older sister] wanted to show her, so she 
showed her how to use it and told her [talking 
ceased briefly] . I told her, "Well, when you be 
like this, you have to take baths more often than 
you do when you're not, cause if you don't, you're 
going to smell." I told her to make sure to take 
baths, because if she doesn't, its going to smell 
and people will say stuff about it. I had no 
problems with her this first time. She took her 
baths when she got up and did what she ought to. 

(ID, 6837) 

This mother identified the menstrual flow as odorous and 
making young girls feel unclean and uncomfortable. She 
recognized that mothers, or older sisters, can direct young 
girls on how to use and change sanitary pads to help in 
cleanliness and the avoidance of unclean body odor. The 
young girl participant in this narrative was instructed on 
the importance of morning baths. Further, she feared taking 
medicine of any kind, tablets or liquids. Her mother had to 
comfort her since she refused to take medicine for relief of 
pain associated with her menstruation. 

A 10 -year-old early-maturer discussed how she achieved 
physical comfort during her menarcheal flow: 


I did have stomach cramps, but grandma gave me 
Tylenol. I took a bath. I took lots of baths. 
The smell was bad. I used pads to keep my clothes 
clean, just had to change a lot. Grandma showed 
me how to use the pads . 

(ID, 1000) 

Some participants took Tylenol, purchased over-the-counter 
(OTC) as a non-prescription medicine, for its effectiveness 
in relieving abdominal cramps. The young participants were 
conscious of the need to change pads and to bath for odor 
control . 

This 10 -year-old commented on her use of several OTC 
medicines for pain relief: 

I can't stand any kind of pain, cause I don't want 
to hurt. Only thing that bothered me was my 
stomach. I can't stand pain, and I take these 
medications. [Investigator asked: "What are the 
names _ of the medications?] Ah, Tylenol, Vanquish, 
Aspirin. Anything mom gives me, I just take them'. 
I took two baths a day and I washed every time I 
changed the pads. Bathe, bathe, bathe. 

(ID, 2750) 

She named three OTC pharmaceutical agents available for 
purchase without visiting the doctor for prescription 
medicines. Her mother was in charge of administering the 

Some early-maturer participants required privacy for 
relief of discomfort. The following early-maturer commented 
on how privacy, OTC, and warmth helped to make her 
comfortable during the menstrual flow. She stated: 


I was soooo sick, I stayed home, didn't go to 
school or anywhere. I thought I would throw up. 
My back hurted, my stomach hurted, I had a 
headache, my legs hurted. Mama put a heating pad 
on my back and I stayed in the bed. . . She gave me 
Tylenol for the pain and my headache... I was sick 
for two or three days . 

(ID, 5483) 

This participant used privacy to decrease the number of 
stimuli she had to deal with during menarche. She elected 
to stay at home on school days for assurance of solitude for 
privacy. A heating pad provided her with a vasodilatory 
effect for relaxation and relief of abdominal and back pain. 
She complained about physical discomfort for up to two or 
three days . 
Hygienic Measures 

Cleanliness of the genital area was essential for 
participants during the menstrual flow. Participants 
articulated that the primary goals of various hygienic 
measures were to prevent body odor and menstrual blood 
drainage onto the young girl's underwear and outer clothing. 
Cleanliness at menstruation provided participants with a 
form of secrecy and privacy by keeping others from learning 
about their menstrual flow being in process. 

A response by this 55 -year-old middle-class mother 
addressed the use of menstrual supplies and what to do in 
situations when commonly used menstrual products are 
unavailable. The mother stated: 


When I found out, I made sure she had plenty of 
pads, clean underwear, and everything, so if, you 
know, something happened, she would be able to put 
on clean underwear and stuff like that... [Mother 
turned to speak to daughter in a teaching manner.] 
Put a little toilet paper in your underwear, and 
it will keep your panties from being stained. If 
you're ever off somewhere, you can always put a 
little tissue or something in your panties. 
That'll kind of cover you till you can get your 
sanitary needs. Try not to let it get on your 
clothes, cause like I say, its embarrassing. 
People know it happens. People laugh. Children 
might laugh. So that would really be 
embarrassing. So that's why I say if you see it 
coming and you're in school and you can't get to 
the teacher, put a little tissue in your panties 
until you get to your teacher and tell your 
teacher or whatever... I encouraged her to wear 
dark clothes for about 2 or 3 days. That's what I 
did. She wore slacks and shorts. 

(ID, 1844) 

This mother participant identified menstrual supplies needed 
for hygienic measures as sanitary pads, plenty of clean 
underwears, and dark clothing. She taught her early-maturer 
how to improvise sanitary pads with tissue when without 
commonly used menstrual pads. The early-maturer was 
reminded to focus on making sure the public did not learn 
that her menstrual flow was in process. The mother pointed 
out that some children will laugh and make fun of a 
menarcheal girl if blood is seen on her clothing at or near 
her genital area. This mother's message was that young 
girls need to follow hygienic measures that will prevent 
embarrassing situations at menstruation since blood is red 
and is easily visible on white and pastel colored clothing. 
Therefore, this mother participant instructed her early- 

maturer to wear dark colored clothings during the menstrual 

In the following statement, a 10-year-old participant 
discussed why she did not wear white clothing or use tampons 
at menarche: 

I didn't wear white clothes or light colors cause 
it might have leaked through and showed up. And I 
used the pads cause I'm scared of the tampons; 
they might not come out. 

(ID, 2750) 

The early-maturer participants recognized that sanitary pads 
are placed in the seat of panties for lining purposes. As 
the menstrual blood flows from a young girl's vaginal canal, 
it will drain onto the sanitary pad. This participant was 
aware that unlike sanitary pads for panty lining, tampons 
must inserted into a female's vaginal canal. She feared 
using the tampon because once inserted into the vaginal 
canal it may not come out. For her, then, sanitary pads are 
easily visible and removable. Wearing sanitary pads and 
clothing of dark colors were effective menstrual hygienic 
measures for some of the participants in preventing 
embarrassing situations and in keeping their menstrual flow 
a secret and private matter. 

Participants discussed knowing that sanitary pads must 
be changed. Saturated pads cause foul body odor and 
overspilling onto underwear and outer clothing. The act of 

pad- changing, however, was bothersome for some of the early- 
maturer participants. A 40-year-old mother stated: 

We had to figure out a schedule to change the pad 
to keep the odor down. She realized she had to 
bathe a lot more and be conscious of her body odor 
at that time. I think that's more inconvenient 
than just bathing once a day. Then the sanitary 
part of keeping her underwear clean from the 
overspills and stuff like that is inconvenient. 

(ID, 9533) 

This mother participant pointed to the inexperience of 
early-maturers with the care of their bodies associated with 
changing menstrual pads and bathing. Some mother 
participants designed a time schedule for pad changing and 
frequency of baths at menstruation. Some of the early- 
maturers had play on their minds instead of the activities 
related to managing their menstrual flow; they required a 
schedule as a reminder to change pads. 

On school days, early-maturer participants left their 
homes where menstrual hygienic items were maintained. As 
such, they were taught by their mothers how to have 
menstrual supplies in their possession when at school away 
from home. This 9 -year -old explained how she managed her 
hygienic menstrual products in the following comment: 

I don't like dresses. I wear pants. But mom made 
me a cycle package. [Investigator asked, "A cycle 
package? What did it have in it?"] It had pads, 
panties, pants, and powder. [Investigator asked, 
"What did you carry these items in?] My backpack, 
I put it in my backpack. 

(ID, 9533) 

This early-maturer found her backpack was useful for 
carrying menstrual hygienic products. Items stored in her 
backpack at menstruation during schooldays included sanitary 
pads, panties, pants, and powder. Her menstrual cycle 
package helped her to have easy access to products needed 
for practicing hygienic measures while away from home. 

Another early-maturer commented on her realization that 
she had to carry menstrual supplies to school. This 10- 
year-old stated: 

It came through my clothes three times at school, 
so I made sure I had extra pads and an extra pair 
of shorts or pants just in case. 

(ID, 1776) 

Just in case the menstrual flow seeped through or spilled 
over the sides of the sanitary pads onto her clothing, she 
had extra supplies on hand so that she could change soiled 
clothing if needed. If a menstrual accident should happen, 
then, advanced preparation helps to prevent embarrassing 
menstrual moments and helps to preserve "private time" at 

Some children will take advantage of an opportunity to 
ridicule and humiliate a schoolmate. The following 
statement made by a 3 8 -year -old middle -class mother shows 
support of previous statements made by other respondents. 
She commented: 

She had to take extra precautions. She takes gym 
clothes, or things. With school, she had to be 
sure that she didn't bleed through, ah, stain her 


clothes, cause kids can be very vicious, cruel at 
times. It might be embarrassing for her. 

(ID, 0201) 

This mother recognized that stained clothing from menstrual 

blood will give some school children a chance to be cruel 

and vicious against an early-maturer . Appropriate hygienic 

measures by early-maturer participants relative to having 

extra supplies on hand were believed to help ward off such 

laughable opportunities for insensitive schoolmates. 

As previously noted, early-maturer participants and 

their mothers believe that the type of clothing worn at 

menstruation is important in preventing embarrassing 

moments. Pants instead of dresses were worn by some of the 

early-maturer participants during their menstrual flow. 

Statements from the following 10 -year-old early-maturer and 

her 29 -year-old mother described why it was beneficial to 

wear pants instead of dresses. The 10 -year-old early 

maturer stated: 

I wear jeans. I don't wear dresses. When it was 
on I wore my jeans and shorts. They're tighter 
and they held the pad in place. 

(ID, 6837) 

The 29 -year-old mother used an incident from earlier 

experience with menstruation to comment on public 

embarrassment when her pad was not securely lined in her 

panties. The mother stated: 

It would be embarrassing if they fell out, but it 
happened to me when I was in school. I was out to 
P.E. (Physical Education) running in a dress. All 
of a sudden they said, "You dropped something." I 


looked back and it was a pad. I said, "Oh gosh!" 
[Lively laughter from daughter.] 

(ID, 6837) 

Some participants thought that most pants and shorts are 
designed to give females greater security in helping to hold 
sanitary pads in place than dresses or skirts. Pants 
provide an extra seat to complement the seat in young girls' 
underwear during the menstrual flow. With the extra 
protection that pants give to hold a pad in place, 
participants indicated that an early-maturer could 
participate in school activities requiring speed and 
exuberant movement without fear of sanitary pads falling 
from their panties and being laughed at. Consistently, 
early-maturers could live privately about their menarcheal 

Preparation for Subsequent Flows 

Menarche is the initial menstrual flow (Golub, 1992) . 
Subsequent flows usually follow menarche on a monthly basis 
(Guyton & Hill, 1996) . Early-maturer participants were told 
that their first menstrual flow was a sign that many more 
flows will follow. Mother participants prepared young girls 
by informing them when to expect their next menstrual flow 
and reminded them to have menstrual supplies on hand. A 55- 
year-old mother prepared her 10 -year-old early-maturer for 
subsequent menstrual flows in the following statement: 

Well, like I told [her], we'll work through it. 
It's just something that's going to happen. All I 


can say is that it's something that we ladies have 
every month. Some people come every 28 days, some 
come every 21 days. It's just depending on the 
cycle, I'm not sure. And I mean, you know, it's 
gonna come, and you can't make it stop. But when 
it comes, you just have to be prepared for it. 
Sometime I might tote my things in my bag for a 
week, cause I'm just not sure... I always get 
prepared like the week before, I start carrying my 
things cause I don't ever know when it's going to 
catch me. You have to be prepared. 

(ID, 1844) 

This mother participant labeled menstruation as a monthly 
cycle. At its onset, according to this mother, a young girl 
should be prepared with available menstrual supplies, which 
may require carrying a sanitary pad for about a week before 
the flow begins. 

Menarche was not a positive experience for many of the 
participants in this study. As a result, most girls did not 
care to know when their next menstrual flow was expected. 
Some mother participants went to the length of using a 
calendar to explain to their early-maturers when to expect 
their next flow. In spite of specific and concrete 
explanations, some early-maturer participants were not able 
to readily recall when their next menstrual flow should 
start. This 9 -year-old early-maturer stated: 

I don|t know when it's supposed to come on again 
[Looking at mother for an answer. Mother 
whispered the word "calendar".] A calendar? Oh 
yes. There's a calendar in my bathroom about when 
its supposed to come. [Shaking head up and down 
while speaking.] We marked a calendar. [Relaxed 
in the chair and started swinging legs back and 
forth in a rhythmic and comfortable manner.] 

(ID, 9533) 

In response to using the calendar as a reference for the 
next menstrual flow, this 9 -year-old's mother picked up on 
the conversation and commented: 

I went over the calendar with her. How to keep up 
with it when it comes on again. I don't think she 
quiet understands it at this point. But I will 
check her bathroom for pads like I did during the 

(ID, 1057) 

This mother recognized that her early-maturer showed little 
interest in repeating an experience with a similar event 
evaluated to have been unpleasant. The mother participant 
discussed the fact that preparation for her next menstrual 
flow must be dealt with. This early-maturer, however, 
turned such preparation tasks over to her mother. 

Nine and ten year old African American females who 
experience menarche are also encountering a major life 
event. Their families, especially mothers and fathers, are 
aware of and responsive to this life change. Findings 
indicate that mothers, especially, are sensitive to and 
concerned about the initial experiences that their daughters 
have. Their responses range from concerns about their 
daughters in several areas, including boy- girl 
relationships, pregnancy, cleanliness, body odor, and 
changing roles and responsibilities of the young girl. They 
characterize these concerns as "private business." 

Fathers, on the other hand, feel uncomfortable 
discussing content related to menarche, cleanliness, body 
odor and other "female"things. They tended to think that 
these issues were specific for the wives. They did, 
however, voice concerns about the young girl's relationships 
with males. The father's reactions ranged from fear to 
planned expectations. The fathers who expressed fear had 
reflections about their own earlier sexual life experiences. 
Many of them remembered active sexual expressions with young 
girls, and felt that because of their previous behaviors, 
their daughters would be confronted with sexual prowess from 
young men and perhaps older men too. They were not sure how 
to deal with these fears. A pattern did emerge; the men 
delegated the young girls' safety to their mothers. The 
fathers' concerns clearly included pregnancy prevention 
through abstinence of sexual expressions. They, along with 
the mothers thought that the young girls' menarche was 
"private business." 

Young girls who experienced the menarche were usually 
not, as a rule, ready for the physical changes in their 
bodies. They perceived themselves as being psychologically, 
socially, and physically different than they were the days 
before the menarche. Few, however, announced their menarche 
to their parents or other caregivers with some sense of 
mastery and expectations. In general, the girls thought 
that everyone would know that they had reached menarche. 

Feelings of shame, confusion, and self - transparency were 
dominant themes in their expressed thought. They were also 
concerned about "how to manage the menstrual flow" 
especially when away from home. The young girls made plans 
for self -care during the menarche while at school; they 
carried extra supplies such as sanitary pads, underwear, 
pants, and shorts to school. They expected and received 
emotional, psychological, and physical support from their 
mothers and fathers. Feelings about others knowing that 
they had reached menarche included keeping this 
developmental epoch a secret from others. They, too, 
thought that the menarche was their "private business." 

The mothers, fathers, and the young females were very 
much aware that menarche symbolized, among other things, the 
capacity for a girl to give birth to a child. If others 
(boys and men) did not know of the young girls' capacity to 
reproduce a child, then perhaps the young girls would not be 
confronted with so many sexual challenges during their daily 
life routines. One way to decrease the potential for 
challenges was to conceptualize this event as "private 
business" and address all of the ramifications related to 
menarche through "private time" within the confines of their 
families and within their households. 


This research project featured "focused conversations" 
with early -maturing African American girls and their 
mothers. The purpose of the study was to (1) capture the 
social psychological responses of African American girls 
ages 9/10 years to their first menstrual flow, menarche, (2) 
articulate the social psychological responses of African 
American parents to their young daughter's menstruation, (3) 
construct a core social psychological theme to substantively 
describe lived experiences of African American families to 
young girls' menarche, and (4) recommend suggestions for 
culturally sensitive interventions that could be developed 
for and tested among African American girls, ages 9/10, who 
are at menarche. Prior to this research undertaking, there 
had not been a qualitative case study that used early 
maturing postmenarcheal African American girls in "focused 
conversations" with their mothers about their menarche. 
Researchers who examined females' responses to menarche with 
sample members belonging exclusively to the African American 
racial -ethnic group (Scott, Danette, Panizo, & Roger, 1989) 
or with an underrepresentation of African Americans (Lee & 
Sasser-Coen, 1996) failed to obtain reports from their 
participants near or at menarche. 


The four major research questions addressed in this 
study were: 

1. How do African American girls ages 9 and 10 years 
old think and feel about starting their first menstrual 

2. How do African American parents react to the 
menarcheal onset and reproductive capability in their 
daughters who are 9 and 10 years old? 

3. How do 9/10 -year-old African American girls manage 
the care of their first menstrual flow? 

4. What changes manifest in African American family 
members' relationships with each other around the onset of 
menarche in girls ages 9 and 10 years? 

Answers to the four major research questions and 
accomplishment of the research's fourfold purpose were 
achieved through "focused conversations" with 15 mother - 
daughter dyads (30 participants). Fathers' responses to 
menarche were obtained from the young girls and their 
mothers. All interviews were audiotape recorded and were 
done in the participants' home within 2 to 5 days after the 
completion of the young girl's menarcheal flow. Interview 
data were analyzed through a cross -comparison method as 
described by Yin (1994) for constructing theoretical 
formulations from qualitative multiple case studies. A 
comparison of similar or like responses allowed the 
conceptualization of three major domains, which included 

symbolic bleeding, regulating sexual behavior, and managing 
menstrual flow. Living through private time emerged as the 
core social psychological theme used to describe life for 
early maturing African American girls and their parents at 
her menarcheal onset. This core theme, the conceptual 
domains, and subthemes of the domains were used in chapter 
four to describe featured narratives from participants' 
"focused conversations." 

Organization of the Remainder of the Chapter 
The remainder of this chapter is organized under the 
headings of (1) living through private time, (2) self- 
concept, and (3) recommendations. A discussion of the 
significant findings interpreted in chapter four are 
presented in the first two sections of this portion of the 
chapter. These findings are discussed in light of existing 
literature and research studies. However, some responses 
exhibited by early-maturing African American girls and their 
parents in this study were not supported by prior research 
studies done with non-African American samples. 
Recommendations conclude the chapter and are presented as 
implications for the African American family literature, 
nursing, and further research. 

Living Through Private Time 
As the core social psychological theme, living through 
private time is theoretically formulated by three main 
conceptual domains and several subthemes to the domains. 

Living through private time is guided by beliefs, values, 
and principles about menarche as a private and secret 
developmental life- event for the early-maturer and her 
family. The properties of the domains identified within the 
subthemes portrait specific social and psychological 
behaviors of participants for use as descriptions and 
explanations about human responses to menarcheal onset in 
early-maturing girls. Living through private time, then, is 
a phenomenological theme about the life -lived experiences of 
early-maturing 9/10 -year-old African American females and 
their parents to menarche. 

For developing young girls, living through private time 
is age and racial -ethnic specific, but not socioeconomic 
status. It addresses only girls of 9/10 years old who are 
members of the African American racial -ethnic group. 
However, behaviors of early-maturing girls at menarche 
across various types of home environments are characteristic 
of this core theme, which is unlike females' behaviors 
reported by other researchers who only examined females from 
middle-class homes (Caspi & Moffitt, 1991; Grief & Ulman, 
1982; Koff & Rierdan, 1995; McGrory, 1990; Scott, Danette, 
Panizo, & Roger, 1989; Stone & Barker, 1939). 

Gordon Allport (DeCarvalho, 1991) once encouraged 
investigators to go directly to the people and ask them how 
they feel and think about their life -lived experiences to 
specific events. Unlike themes about menstruation from 

qualitative studies put forth by Lee (1994) and Lee and 
Sasser-Coen (1998) , living through private time represents 
the voices of young girls and that of their parents at the 
time of the girl's menarcheal onset, not many months and 
years beyond the occasion. In this way, living through 
private time provides descriptions and explanations of the 
phenomenological essence of "being" and the conceptualized 
"self" of the 9/10 -year-old African American girl and that 
of her parents to the young girl's first menstrual flow. 
Symbolic Bleeding 

Menarche is a symbol recognizable by vaginal bleeding. 
Blumer (19 69) asserts that humans behave toward things, 
objects, and events based on their understanding and based 
on associated meanings. Further, the meanings of things are 
learned through social interaction with one's fellow human. 
The conceptual domain, symbolic bleeding, addresses the 
behaviors of young girls and their parents to her menarche. 
Thus, young girls, mothers, and fathers exhibited behaviors 
specific to their understanding of menarche and their social 
interaction with each others. The subthemes to symbolic 
bleeding that evolved from participants responses include 
philosophical belief, emotional responses, at another time, 
sexual sensuality, and private business. 

Girls.. Young girls responded to their menstrual fluid 
with a sense of shame and embarrassment. Most of them cried 
(8 of 15) and spoke of their fear about "bleeding" from a 

private body are; as such, menarche was symbolic of 
bleeding. McGrory (1990) reported shame and embarrassment 
were common responses from young girls about menstruation. 
Amann-Gainotti (1986) validated that some girls were afraid, 
because they did not know what was happening to them and 
they believed they were going to die. Most girl 
participants (13 of 15) in the study believed menarche was 
an event for older females since it interfered with their 
play activities and should come at another time when their 
interests and lifestyle changed from being a playful child 
to being a more serious -minded mature young lady. On the 
other hands, a few girls (2 of 15) perceived menarche to be 
a sickness symbolized by vaginal bleeding; it should come at 
an younger age so the young girl could be pampered by her 

Girls complained about the sanitary pads being bulky, 
uncomfortable, and aggravating. Some of the girls believed 
it was a laughable notion to think that they could become 
pregnant at an early age; no prior research study was 
located to support this behavior. Even when girls were 
excited about their menarcheal onset, they believed it 
should not be broadcasted since it was a young girl's 
"private business." Although several researchers reported 
similar responses from sample members about menstruation 
(Brooks -Gunn & Ruble, 1980; Hill, Holmbeck, Marlow, Green, & 
Lynch, 1985; Chadwick, 1992; Lee & Sasser-Coen, 1998), many 

of these responses articulated by early-maturer participants 
in this study were not located in previous studies. 

Mothers . Mothers voiced being worried, apprehensive, 
nervous, and fearful about the childbearing capabilities of 
their early-maturing daughters. They also expressed 
feelings of guilt and hurt if they were not present with 
their daughters at the appearance of menarche. Mothers who 
were not expecting their young daughters to menstruate by 
9/10 years old, were stunned to learn their daughters were 
menstruating. Fathers placed added pressure on mothers to 
prevent their daughters from participating in sexual 
activities. As a result, most mothers felt stressed with 
the advent of their daughters' menarche. Prayer and trust 
were used by several mothers as a basic way of coping with 
the "private business" of having an early maturer 
menstruating at age 9/10 years old. With the exception of 
religion, Holmbeck and Hill (1991) validated these findings 
in their study of middle-class White family members' 
responses to the young girls' menstrual flow. 

Fathers. Some fathers believed the onset of their 
daughters' menstrual flow was triggered by sexual activities 
with young boys. From the fathers' perspectives, menarcheal 
onset in early-maturers symbolized sexual readiness. 
Mothers were often time blamed by fathers for its early 
onset in their daughters. However, some fathers felt guilty 
about using other young girls and women as sexual objects 

during their earlier years as developing males. They feared 
their menarcheal daughters would lose their virginity and be 
sexually abused by young boys; this would occur as an act of 
revenge and retaliation for their use of young girls as 
sexual objects. Fathers preferred that their daughters' 
menarche be treated as "private business" to protect them 
from young males in search of menstruating young girls to 
use for sexual gratification. Although Guyton and Hill 
(1996) described the biophysiological effects of sexual 
foreplay acting as neural messengers to the brain for 
stimulation of sexual urges and desires, research evidence 
was not located to support those fathers' belief about how 
early entry into sexual activities initiating menarche in 
young girls. 
Regulating Sexual Behavior 

Most (61%) of the early-maturers in this study lived in 
nuclear families and were not known by their parents to be 
sexually active. However, two (13%) of the early-maturer 
participants were known to be sexually active. Several 
researchers noted that early-maturing girls are more likely 
to engage in sexual activities at an earlier age than their 
counterpart (DuRant & Seymour, 1990; Leite, Everardo, 
Buonocompagno, & Leite, 1994; Masters, Johnson, & Kolodney, 
1992; Prendergast, 1993). One young girl participated in 
sexual intercourse while the other participated in oral sex. 
Both sexually active girls lived in underresourced homes 
with single-parents. Vinovskis (1988) reported similar 

results about the sexual practices of young girls living in 
low socioeconomic conditions. 

Four strategies were used by parents to regulate the 
sexual behavioral activities of their early-maturing 
daughters. These strategies are the subthemes to this 
domain and they include gender sexuality scripting, cross - 
sex segregation, parental supervision, and good company. 
Through gender sexuality scripting mothers socialized their 
daughters about "ladylike" behaviors. Some of the early - 
maturers reported that their fathers "got rid of" or "ran 
off" their boyfriends for cross -sex segregation. 

Girls were discouraged by parents from socializing with 
friends who were known to be "bad girls" involved in sexual 
activities and teenage mothers. Although fathers helped to 
regulate early-maturers ■ sexual behaviors, mothers were 
primarily responsible for using these strategies to prevent 
early-maturers from engaging in sexual activities and to 
prevent pregnancy. These strategies are similar to the ones 
described in the literature (Bagley, 1997; Casper, 1990; 
Costa, Jessor, Donovan, & Fortenberry, 1995; Dean, Ducey, 
Malsk, 1997) . 
Managing Menstrual Flow 

This domain has four subthemes, which include mother's 
significance, comfort measures, hygienic measures, and 
preparation for subsequent flows. The early-maturers 
depended on their mothers to guide them in managing their 

menstrual fluid and the physical discomforts accompanied the 
menstrual cycle. Many of the girls were without a clue 
about how to care for themselves at menarche. As compared 
to the fathers, mothers were seen as being more significant 
because of their life- lived experiences with menstruation 
and their identification with the early-maturers as members 
of the female gender sex. Swenson, Foster, and Asay (1995) 
reported similar findings in their research concerning the 
educational preparation of young girls about menstruation. 

Several measures were used by young girls with the help 
of their mothers for menstrual management. Girls were 
encouraged to bathe and were taught to change sanitary pads 
by a schedule. Most girls were particularly concerned about 
their self -concept and expressed concerns about body odor 
and the noticability of the bulky sanitary pad. Some girls 
took baths more than usual in a day and most girls changed 
their dress attire to make sure the pad was secure and not 
visible to others. The blood flow was considered smelly, 
time-consuming for cleanliness, and a nuisance. Dashiff 
(1992) noted similar findings in her research study. Other 
researchers also validated these findings (Brooks-Gunn & 
Ruble, 1980; Clark & Ruble, 1978; Hill, Holmbeck, Marlow, 
Green, & Lynch, 1985; McGrory, 1990; Scott, Danette, Panizo, 
& Roger, 1989) . 

Self -Concept 
Self -concept emerged from participants' responses and 
is deeply interwoven in phenomenologic humanism; symbolic 
interactionism; human growth and development; and the 
psychological transition from childhood to "womanhood". 
From a discussion of the core theme and its conceptual 
domains, the onset of menstruation among young African 
American 9/10 -year-old girls should not automatically be 
perceived as always being pleasant and ego enhancing 
(Doswell & Vandestienne, 1996; Grief & Ulman, 1982) . As 
described in the conceptual domains of symbolic bleeding and 
regulating sexual behaviors, tremendous biophysiological 
changes take place in young girls' bodies that lead to 
menstruation and alteration in their social and 
interpersonal relationships with friends, peers, and family 
members. Researchers (Bios, 1962; Caspi & Moffitt, 1991; 
Fox, Page, Armstrong, & Kirby, 1994; Rierdan, Koff, & 
Stubbs, 1987) have validated that these changes impact 
early-maturing girls' self -concepts, which include their 
self-esteem and self-image (Harter, 1990). 

Eleven early -maturers in this study experienced 
menarche at 10 years old; the other four were 9 years old. 
This age of menarcheal onset is consistent with a national 
report done by the American Academy of Pediatrics on African 
American young girls (Herman -Giddens et al . , 1997) and with 
findings reported by other researchers (Doswell & Millor, 

1993; Doswell & Vandestienne, 1996; Phinney, Jensen, Olsen, 
& Cundick, 1990) . According the responses from the 
participants in this project, the early occurrence of 
menarche posed some difficulty for them relative to their 
emotions of shame and embarrassment. They were concerned 
about their body- image from the standpoint of foul odor and 
the appearance of wearing bulky sanitary pads. 

Based on the themes extracted from the research data, 
self-concept is discussed under self-image and self-esteem 
and as important components of "private time." The Chapter 
will conclude with specific recommendations for the practice 
of nursing and for further research. 
Self - Image 

Self-image is a critical factor that is directly 
related to the data generated in this research. African 
American females have not traditionally been included in 
research regarding reproductive (Leigh, 1995) and 
psychological health issues (Graham, 1992; Reid & Kelly, 
1994) . When sociological and psychological components of 
reproductive health are considered among African American 
females, its specificity and sensitivity are sometimes less 
than desired. Perhaps a difference in cultural values among 
the dominant White group and African American group is one 
explanation for the exclusion in research studies (Feagin & 
Feagin, 1994, 1996; Staples & Johnson, 1993; Willie, 1985). 
Negative stereotypes about African American females, 

especially as it relates to sexual maturity and expression 
could also be another component (Chilman, 1990; Gutman, 
1976; Hyde, 1996; Rainwater, 1966; Staples, 1978;). 

Blumer (1969) asserts that the self emerges from social 
experience and is not merely a passive reflection of social 
norms. Social experience deals with the exchange of symbols 
and is essential to the development of a young girl's self. 
As developing young ladies, early-maturing African American 
girls are faced with numerous racial -ethnic historical and 
sociological factors that will influence their self-image, 
how they perceive themselves as menstruating females in a 
society that has negatively represented them historically 
(Hacker, 1992; Hill -Collins, 1990; hooks, 1989; Reid & 
Kelly, 1994) . Some of the mother participants used 
interview time to socialize their daughters about "ladylike" 
behaviors and the importance of not being sexually active. 
A young girl's self-image begins with her body- image. 
Body- image is the mental representation of the self 
(Erikson, 1963; Harter, 1990). It is essential to the young 
girls' physical, psychological and social development as 
early-maturers. About 40 years ago, Bios (1962) suggested 
that a female's sexual drive is more directly linked to ego 
interests and interpersonal relationships than is the 
male's. Young females, without support and guidance, will 
tend to focus on how they look, and less on how they feel, 
or what they think, or what their capabilities for future 

contributions to society can be (Barone, 1995; Dusek, 1991; 
Harter, 1990; Lee, 1994; Pipher, 1994). Pipher (1994) has 
also written that the young girls' thoughts are dominated 
with how they look. Girls in this study expressed concerns 
about how wearing the sanitary pad hindered their usual 
casual and comfortable attire. Some of the girls expressed 
a need to be accepted by same -age friends and peers. Most 
studies about the developmental issues in young girls 
focused on affective domain of the body- image. The focus 
was on the association between feelings of dissatisfaction 
regarding the physical self and attitudes toward body 
weight, mood, global self-esteem, and other image related 
behaviors (Doswell, Millor, Thompson, & Braxter, 1998; 
Leigh, 1995; Stein & Hedger, 1997). 

Early adolescence, according to the interview 
responses, was not a smooth linear process for the girls in 
this study. Instead, it had many disruptive features, was 
not necessarily calm and was definitely not described as 
quiescent. This tumultuous transition from the playstage of 
childhood to the "ladylike" behavioral period of early 
adolescence is supported by the literature (Baumrind, 1993; 
Bronfenbrenner, 1997; Erikson, 1963; Scarr & McCartney, 
19 83) . The early experience of menarche was a chaotic and 
an awkward event in the lives of some of the young 
menstruating African American participants. The onset of 
the menarche was a frightening and fearful experience for 

some of the early-maturer participants and their parents. 
It signaled the capacity for the child to reproduce another 
human being. Along with this reproductive capacity was the 
growing concern among the young girls that they could not 
interact with others as they once did. Parental supervision 
and restrictions forced a change in their social contacts 
and activities with opposite- sex playmates. In some 
instances, a certain suspicion "set in" the minds of their 
mothers and fathers about sexual activities with opposite- 
sex friends and playmates. Physical discomfort, a need to 
bathe, bathe, and be clean, was stressed by their mothers. 
However, their growing need for knowledge, support and 
guidance during this stage of development was almost 
insatiable as validated by the literature ( Doswell, Millor, 
Thompson, & Baxter, 1998; Bios, 1962; Moffitt, Caspi, 
Belsky, & Silva, 1992) . 
Self -Esteem 

In the recent past, self-esteem was a concept that was 
associated with esoteric thought. That era has passed, and 
the concept can easily be utilized to explain and describe 
human behaviors and thoughts in many contexts. Self-esteem 
consists of wMsat an individual feels that others think and 
feel about the individual. It also includes the 
self -perpetuating internal images that one has about the 
self (Malmquist, 1972). Young girls' thoughts and feelings 
about how others feel and think about them is internalized 

within the self, and help to form their core self, which is 
the structure on which their self-esteem rests (Malmquist, 
1972; Pipher, 1994). That is to say, self-esteem includes 
the beliefs, opinions, values, attitudes, dreams, 
aspirations, thoughts, and feelings about the self. It 
comprises a comprehensive evaluation mechanism by which the 
individual can determine self -worth or self importance 
within the context of family, community, and society 
(Doswell, Millor, Thompson, & Braxter, 1998; Malmquist, 
1972) . These comments, sensations, thoughts, feelings, and 
behaviors are stored internally where the young girl will 
have their use for a life time (Malmquist, 1972) . Hence, 
the development of menarche should be perceived not only as 
a physiological milestone, but as the bedrock on which the 
young girl will gather and store memories of early sexuality 
(Lee, 1994; Malmquist, 1972). These memories will remain 
within her armamentarium of behaviors. 

High self-esteem helps an individual to complete a self 
evaluation within the reality of a situation, while 
stressing his or her strengths and weaknesses. On the other 
hand, an individual with low self-esteem is more likely to 
evaluate the self as unworthy, unfit, and or incapable. 
Pipher (1994) posits that young girls, by the time they are 
in early adolescence, are experiencing some universal and 
phenomenal behavioral changes, among which are conformation, 
withdrawal, depression or anger. Some, but not all, girls 

react by expressing all four of these behaviors. The 
observer will notice that the girls have lost their 
vibrancy, their energy, and their inquisitive personalities. 
At the end of the continuum is the loss of self-esteem, the 
consequent response to losses, or to frustrations related to 
attaining personal goals and objectives ( Malmquist, 1972) . 

The onset of menarche could trigger the potential 
upset of personal self-esteem in young African American 
females. Should this upset occur, and remain within the 
self or core of the young girl, the potential for high risk 
behaviors and other self defeating acts could be a likely 
consequence. Among African American females, the onset of 
early menarche could signal the potential for the erosion of 
self-esteem. Many of these young girls may not have been 
raised in families and neighborhoods where much attention 
was given to self-esteem, self-image, and life-events. 

Given the mothers ' and fathers ■ expressed 
vulnerabilities to the sexual predators who live within the 
neighborhoods and have limited respect for a young girl's 
privacy and personal business, they, at the onset of the 
menarche, might be at risk for sexual advances from these 
males (Klein, 1996) . Fathers who are active in their 
families, who have knowledge about the risks that their 
daughters could confront, and who can effectively 
communicate with their wives and daughters, provide a 
powerful buffer and protective shield for their young 

menstruating daughters. Despite the roaming community of 
predators, research has indicated that African American 
girls have self-esteem equal to or higher than their white 
counterparts (Cross 1991; Tashakkori & Thompson, 1991; 
Tashakkori, 1993). This critical attribute, high self- 
esteem, in African American girls is worth preserving. 

Given the dramatic physical changes that occur in the 
female gender, the developmental epochs must be briefly 
discussed. Females' maturity is difficult to shield. 
Breasts, bodily curves, are undeniably present. Too, the 
girls' personal concerns with physical attractiveness, make- 
up, cloths, perfumes, coupled with peers' interest in and 
"talk about boys" place them in a sensual mode. The desire 
to be physically attractive is associated with high self- 
esteem, and reflects the internalization of the acquired 
self. But early-maturers could be at risk because they are 
outside of their age appropriate maturation phase (Bios, 
1961; Koff, Rierdan, & Jacobson, 1981; Malmquist, 1972; 
Slap, Khalid, Paikoff , Brooks-Gunn, & Warren 1994) . 

Most researchers and clinicians would agree that the 
young girl's self-esteem is fragile, and must be nurtured 
and protected. This fragility will exist throughout the 
adolescent sequence, including preadolescence, 
middle-adolescence, and late adolescence (Bios, 1962; Dusek, 
1991) . A study by Simmons, Blyth, Van Cleave, and Bush 
(1979) indicated that those young girls who tend to mature 

earlier, are more likely to report lower self-esteem scores 
when compared to the girls who mature within the predefined 
timeline. It is not clear from these data whether the young 
girls had high or low self-esteem; that was not the focus of 
the study. What is clear, however, is that all of the girls 
reported feeling vulnerable in some manner, and wanted some 
type of parental protection and affection. Recall that one 
young girl wanted to be held in her mother's arms and rocked 
like a young baby. This behavior suggests regression, 
fright, vulnerability, and a threatened self-esteem. 
Fathers and mothers can make the critical differences in 
their daughters' lives by communicating, nurturing, caring, 
and protecting their children. 


Recommendations are presented in this section under two 
headings, which include implications for the African 
American family literature, implications for nursing and 
implications for further research. 
Implic ations for the African American Family Literature 

This study makes a contribution to the literature about 
life for the contemporary African American family with 
early-maturing 9/10 -year-old daughters. Traditionally, the 
African American family was portrayed as a social problem 
and a financial burden to the White -minded American society 
(Demos, 1990; Feagin & Feagin, 1994; St. Jean & Feagin, 
1998) . With the advent of racial integration in the 

Southern regions of the United States during the 1960s, 
Moynihan (1967) put forth the "culture-of poverty" thesis to 
describe the African American family as problematic for 
White America. Many researchers, White and non- White, 
relied heavily on data from African Americans who were 
financially poor, uneducated, female- single-parents with 
several illegitimate children, and who lived in the worse of 
conditions. Further, fathers were often time reported as 
being uninvolved with childrearing practices (St. Jean & 
Feagin, 1998) . The data were used to report a "culture-of - 
poverty" and matriarchal images of "family" life for people 
of the African American group (Demos, 1990) . 

Living through private time is a theme that embraces 
various types of home life for the 9/10 -year-old African 
American girl at menarche. Sample members represent few 
girls (13%) who lived in the poorest conditions. Most girls 
(60%) reside in nuclear families and few (20%) have families 
at the poorest socioeconomic level. The average yearly 
income for the African American families in this study is 
$39,800. All but one parent completed 12 years of 
education; some parents earned 4 -year college degrees and 
one parent had 2 years of doctoral education. The 
narratives show that most biological fathers (80%) are 
involved with childrearing practices, which include those 
fathers not living in the same dwelling with the mother and 
the early-maturer. Most girls (87%) were not involved with 

sexual activities according to the narratives. The data 
from this study, then, has implications for the literature 
about the lifestyle of African American families at menarche 
with their early-maturing daughters. 
Implications for Nursing 

Living through private time has implications for the 
practice of nursing. This core theme acknowledges the fact 
that 9/10 -year-old African American girls are experiencing 
menarche, menstruating, and some are sexually active. Thus, 
nurses are in a position to educate young African American 
girls prior to menarche about their maturing bodies within 
the context of their capacity to process and understand this 

Early-maturers should be taught information about their 
reproductive health, ways and means to express their sexual 
desires in a manner that is void of direct sexual 
intercourse. The nurse should recognize that discussions 
about sexuality, ideally, should occur within the family 
unit. The daughter, mother, and father, should be members 
of the discussion groups. Content regarding physiology of 
the female and male reproductive system, the sexual response 
cycle should be cognitively presented and for comprehension. 
This information should serve as a safety net for the girls, 
their mothers and their fathers. Knowledge about the 
physiology of female and male sexuality and reproduction is 
critical for these individuals to understand and will help 

all involved to be more confident and secure in their 
interactions and expectations of each other. In the long 
term, this content could help with the prevention of 
sexually transmitted diseases, the Human Immunodeficiency 
Virus, AIDS, and other deadly diseases. Conceptually, it 
could also help in the reduction of teenage pregnancy 
(Casper, 1990; DuRant & Seymour, 1990) . 

Specific emphasis should be placed on the human sexual 
response cycle. This cycle has four clearly defined phases 
that include follicular, ovulatory, luteal, and menstrual. 
These phases are controlled and regulated by a hormonal - 
feedback system originating in the hypothalamus. Primary 
functions of the menstrual cycle are to prepare the female's 
body for conception and gestation and, the period of 
gestation itself. This framework, described in simple 
terms, can help an early maturing young girl become aware 
of, but not participate in, sexual activities. Armed with 
knowledge and information about the physiology of the female 
and male sexual response cycle, she should be better 
equipped to communicate and make decisions regarding her 
Implications for Further Research 

The nurse researcher and clinician must come to 
understand how young girls come to be who they are. A 
better understanding of their lived experiences, the culture 
and society within which they live, and their dreams and 

expectations, are essential components of their being that 
should be sensitively and knowledgeably researched. It is 
recommended that further studies be conducted to describe 
and predict the emotional impact of early menarche on young 
African American girls. Context -specific interventions from 
research data that focus on menarche and subsequent young 
female reproductive health issues for the purpose of 
assisting the young girl to more effectively cope with 
menstruation need to be developed. Research should be 
designed to determine the extent to which early menarche has 
a negative impact on the young girl's self -concept , body- 
image, self-esteem and perceived relationships with young 
boys and men. A research instrument should be developed 
that specifically focuses on African American girls to 
assess their knowledge, health beliefs, and capacities to 
cope with early menarche. Research projects should be 
developed to teach young boys about their changing physical 
bodies and associated sexual responsibilities, especially as 
it relates to other young females. 

Intervention programs should be developed from research 
reports to strengthen the mothers' knowledge about the 
physiology of menarche and the reproductive system. These 
research programs should include information regarding 
additional roles and responsibilities as related to sexual 
expressions among young males and females, self-esteem and 
body- image concerns. Fathers could be taught to become more 


comfortable with their maturing young daughters and 
additional methods of communicating, protecting, and caring 
for the daughters could be expanded. Further, the father 
should be encouraged to find additional methods of sharing 
the parenting responsibilities for the young girls with 
their mothers. The intent is to strengthen the fathers' 
interactions with the females in the household. 

Roles and responsibilities related to enhancing the 
young girls' self -concept (self-image and self-esteem) are 
essential components for the father and should be researched 
and carefully documented. Lastly, programs that explain and 
describe the critical roles of fathers in the lives of young 
early menarche girls should be developed and carefully 





IRB# /2 7- 9? 
Informed Consent to Participate in Research 

The University of Florida 

Health Science Center 

Gainesville, Florida 32610 

You and your daughter are invited to participate in a research study. This form is used to tell you 
about the study and to obtain your consent. I, Dorothy Hawthorne, am the principal investigator 
of this study. I will describe the study to you and answer any of your questions. If you have any 
complaints or questions about the informed consent process or the research study, please contact 
the Institutional Review Board (IRB), the committee that protects human subjects, at (352) 846- 

1 . Name of Subject 

2. Title of Research Study 

Social Psychological Responses of African American Females at Menarche 

3. a. Principal Investigator(s) and Telephone Number(s) 

Dorothy J. Hawthorne 

b. Sponsor of the Study (if any) 

The Purpose of the Research is to learn more about the feelings and behavior of 9- and 
10-year-old black females at the time of their first period. Also, the purpose is to learn 
how mothers of the females react to their daugthers' first period. 


^•tltutJonal R*vie*v Board £ Q/j 
IRB-01 fir 


"^ * Revised 6/95 


Procedures for This Research 

Procedures for this research involve an interview and the completion of a demographic 
form. You and your daughter will be interviewed together. The first interview will last 45 
to 60 minutes. A second interview may be needed if a topic is not clear. Interviews will 
take place in your home and will be tape recorded so I am certain I understand everthing 
you say to me. The initial interview will be done by the fifth day after your child's first 
period. I will call you on every other Monday or Tuesday to learn if she has started her 

A demographic form must be completed. This form asks for information about your 
child's date of birth, weight, height, and the presence of bulging breasts and genital hair. 
This information will help to learn how soon your daughter will most likely start her 
period. You will be asked to give information on your (or the head-of-the-household) 
education, occupation, marital status, and household income. 

Potential Health Risks or Discomforts 

You or your daughter may be uncomfortable during the interview session. An uneasy 
emotional feeling or a sense of shame may be experienced as we talk about the private 
and sensitive topics about menstruating. Also, some young females cry as they talk about 
their first menstrual experience. If at any point during the conversation you or your 
daughter become uncomfortable, remember that you are free to tell me that you do not 
want to talk about a certain topic or issue. 

If you wish to discuss these or any other discomforts you may experience, you may call 
me at (941) 699-2658. 

Potential Health Benefits to You or to Others 

Your participation in the interview may provide an opportunity for you and your daughter 
to increase your understanding of the way each of you think about being females and 
maturing. Hopefully, your participation in the study will open communication regarding 
changes occurring with your daughter. 

8. Potential Financial Risks 


Revised 6/95 


Potential Financial Benefits to You or to Others 

You and your daughter will each be given a $10 J.C. Penney's gift certificate or one from 
a similar store. You will receive the gift certificates at the time of the interview once your 
daughter starts her first menstrual flow. The gift certificates are a show of my 
appreciation for your participation in this research project. 

10. Compensation for Research Related Injury 

In the unlikely event of you sustaining a physical or psychological injury which is 
proximately caused by this study: 

professional medical; or professional dental; or X professional 


care received at the University of Florida Health Science Center will be provided without 
charge. However, hospital expenses will have to be paid by you or your insurance 
provider. You will not have to pay hospital expenses if you are being treated at the 
Veterans Administration Medical Center (VAMC) and sustain any physical injury during 
participation in VAMC-approved studies. 

1 1 . Conflict of Interest 

As the principal investigator, Dorothy Hawthorne will not get any benefit from this research 
project beyond the professional value from academic publication or representation of the 

12. Alternatives to Participating in this Research Study 

You and your daughter are free not to participate in this study. If you choose to 
participate, you are free to withdraw your consent and discontinue participation in this 
research study at any time without this decision affecting your medical care. If you have 
any question regarding your rights as a subject, you may phone the Institutional Review 
Board (IRB) office at (352) 846-1494. 

13. Withdrawal From this Research Study 

If you wish to stop your participation in this research study for any reason, you should 
contact me, 

Dorothy Hawthorne, at (941) 699-2658 . You may also contact the Institutional Review 
Board (IRB) Office at (352) 846-1494. 

Revised 6/95 


1 4. Confidentiality 

Your privacy is important and the University of Florida will protect the 
confidentiality of your records to the extent provided by Law. Therefore, your 
record will be identified by a four-digit number instead of your true or legal 
name. I will write down exactly what is said from the recorded tape, but no 
names will be recorded. The tape will be erased after the transcribing is done. 
Information from the tape will be used to describe how mothers and daughters 
behave at the time of the young girl's first period. 

1 5. Assent Procedure: 

As a child who is older than 7 years but younger than 18 years, your daughter 
cannot give legal consent to participate in this research project. Therefore, her 
assent is requested. Your daughter's assent shows that the principal 
investigator, Dorothy Hawthorne, explained this research project with words 
that are appropriate for her age and understanding in your presence as the 
parent or guardian. The investigator gave her a chance to ask questions and 
get answers. The investigator asked for her wishes, which she shows 
approval by signing in the appropriate place on the signature page or the 
investigator will document obtaining oral assent below. 

has explained 

(Principal Investigator/Delegate) 

the study to on 

(Name of Subject) (Date) 

The subject has given oral assent to participate. 

(Signature of Principal Investigator/Delegate) 

Revised 6/95 

16. Signatures 

Subject's Name 

The Principal or Co-Principal Investigator or representative has explained the nature and purpose 
of the above-described procedure and the benefits and risks that are involved in this research 

Signature of Principal or Co-Principal Date 

Investigator or representative obtaining consent 

You have been informed of the above-described procedure with its possible benefits and risks and 
you have received a copy of this description. You have given permission for your participation in 
this study. 

Signature of Subject or Representative Date 

If you are not the subject, please print your name 
and indicate one of the following: 

The subject's parent 

The subject's guardian 

A surrogate 

A durable power of attorney 

A proxy 

Other, please explain: 

Signature of Witness Date 

If a representative signs and if appropriate, the subject of this research should indicate assent by 
signing below. 

Subject's signature Date 

Revised 6/95 


Vloa Chairman 

Or. RoMrt L. FiXfaraW 

Highlands County 
School Board 

426 School Stroot » P.p. Bok 8300 • Sebriof , FL 33870-4098 

(941) 471-55SS • FAX (941) 471-5600 • TDD (941) 382-3693 

April 7, 1997 

University of Florida 

Health Center Institutional Review Board 

P.O.Box 100173 

Gainesville, FL 32610-0173 

To Whom It May Concern: 

Ms. Dorothy Hawthome-Burdine requested a copy of information regarding 
names, phone numbers, and addresses of female students of the Highlands 
County Public Schools in grades 3rd, 4th, and 5th for the 1995-96 school 

A copy of this information was given to Ms. Burdine during the summer of 
1 996 as a starting point to identify students who met the criteria for the 


'(A f"* 

Richard R. Farmer 
Superintendent of Schools 


"A fully accradltad school lyilim* 
Southern Aaaoclallon of Coll.g.. and School. 




IRB PROJECT # 127-97 
EXPIRES 04/16/98 

Health Center Institutional Review Board PO Box 100173 

PrinciDal Investigator: HAWTHORNE, DOROTHY ainesviUe. ^l^"?^^ 

Address: P.O. BOX 854 fa SEEKS 


Congratulations on receiving IRB approval to conduct research at the 
University of Florida. Approval of this project was granted on 04/16/97. 
Enclosed is the dated, IRB-approved Informed Consent Form that must be 
used for enrolling subjects into this project. You have approval for 
12 months only. 

You are responsible for obtaining renewal of this approval prior to the 
expiration date. Reapproval of this project must be granted before the 
expiration date or the project will be automatically suspended. If 
suspended, new subject accrual must stop. Research interventions must 
also stop unless there is a concern for the safety or well-being of the 
subjects. Upon completion of the study, you are required to submit a 
summary of the project to the IRB office. 

The IRB has approved exactly what was submitted and reviewed. Any change 

in the research, no matter how minor, may not be initiated without IRB 

review and approval except where necessary to eliminate hazards to human 

subjects. If a change is required due to a potential hazard, that change 
must be promptly reported to the IRB. 

Any severe or unanticipated side effects or problems and all protocol 
deviations must be reported, in writing, within 5 working days. 

Research records must be retained for three years after completion of 
the research; it is recommended that they be retained for eight years. 

If VAMC patients will be included in this project, or if the project is 
to be conducted in part on VA premises or performed by a VA employee 
during VA- compensated time, final approval should be obtained by 
application to the VA Research Office. 

You are responsible for notifying all parties about the approval of this 
project, including your co-PIs and Department Chair. If you have any 
questions, please feel free to contact Barbara Frentzen, at (352) 846-1494 

/> £/ /'/ 
R. Peter Iafrate, Pharm.D 
Chair, IRB -01 

cc: IRB File; Division of Sponsored Research; Rhonda Cooper-DeHof f , 
Pharmacy; Edward Block, VA; Sandra Barnawell, CRC 

Enclosed: Stamped, dated, IRB-approved Informed Consent Form 

Equal Opportunity / Affirmative Action Institution 




Health Center Institutional Review Board 



April 2. 1998 


Dorothy Hawthorne 

P.O. Box 854 

Lake Placid, FL 33862 


R. Peter lafrate. Pharm.D 
Chair, IRB-01 

POBox 1 00 1 73 
Gainesville. Florida 32610-01 "3 
Tele: (352) 846-1414 



IRB Protocol #127-1997 

Expires on 4/1/99 


Approval of this research project (Including the Informed Consent Form and Protocol) was granted on 4/1/98. 
Enclosed is the dated. IRB-approved Informed Consent Form that must be used for enrolling subjects into this 
project. You have approval for 12 months only. 

You are responsible for obtaining renewal of this approval prior to the expiration date. Re-approval of this 
project must be granted before the expiration date or the project will be automatically suspended If suspended, 
new subject accrual must stop Research interventions must also stop unless there is a concern for the safety or 
well being of the subjects. Upon completion of the study, you are required to submit a summary of the proiect to 
the IRB office. 

The IRB has approved exactly what was submitted and revised. Any change in the research, no matter how 
minor, may not be initiated without IRB review and approval, except where necessary to eliminate hazards to 
human subjects If a change is required due to a potential hazard, that change must be promptly reported to the 

Any severe or unanticipated side effects or problems, and all protocol deviations must be reported, in 
writing, within S working days. 

Research records must be retained for three years after completion of the research; it is recommended that they be 
retained for eight years. 

If VAMC patients will be included in this project, or if the project is to be conducted in part on VA premises or 
performed by a VA employee dunng VA-compensated time, final approval should be obtained by application to the 
VA Research Office. 

You are responsible for notifying all parties about the approval of this project, including your co-PIs and Department 
Chair. If you have any questions, please feel free to contact Barbara Frentzen at (352) 846-1494. 

Cc: IRB File; Division of Sponsored Research; 

Rhonda Cooper-DeHoff. Pharmacy; 

Edward Block, VA; 
Sandra Barnawell. CRC 


Stamped, dated, IRB-approved Informed Consent Form 




Date of Birth: 

Address : 





_lbs. Height_ 

Bulging Breasts: YES NO 


Tanner's Stage: 

12 3 4 5 

Hair (Armpit or Genital) : YES NO 


(Mother) :_ 

Marital Status: M D S W 

Highest Grade Completed: 

Degree Received: 


Household Income: 


Marital Status: M D s w 

Highest Grade Completed: 

Degree Received: 


Household Income: 



Open-ended Questions: 

1. What does it mean to have your period? 

2. Tell me about your first period. 

a. What were some of the things you feel you had to do 
differently while having your period? 

b. What are some of the things that you think boys are 
able to do that you are not able to do now that you 
have your period? 

c. What was not the same about your talks or your 
relationship with your mother? Your father? Your 

d. What types of odd (if any) feelings did you have 
with your period? 

e. What supplies (or things) are you using just for 
the period? 

3. What were some of the things you learned about your 
period before you started? Who told you these things? 

4. Now that you have had at least one period, what would 
you do differently with the next periods? 

5. How grown-up do you feel now that you have started your 



6. What types of feelings do you have for boys? 

7. Who have you told that you have started your period? 

8. At what age would you have like to have started your 

9. What words are you using to call (or refer to) your 

10. What are your general feelings about yourself at this 



Open-ended Questions: 

1. What concerns do you have now that your daughter has 
started to menstruate? 

2. What changes have occurred in your talks with your 
daughter and your general relationship with her? 

3. How do you see your daughter now that she has started 
her period? 

4. What types of restrictions have you placed on her 
activities with boys, other girls, siblings, relatives, 
strangers, etc? What school or sport activities have 
you placed a restriction on since she has started to 

5 . What has her father expressed to you about your 
daughter's menstruation now that he knows she is 











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10 4 












9 4 












10 3 












10 4 












10 3 












10 4 












10 4 












9 4 












10 3 












10 5 












10 4 












10 4 












10 4 












9 4 



















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Dorothy Hawthorne was born April 1, 1952 in Sebring, 
Florida as the eighth of thirteen children to Hazel and the 
late Nathaniel Hawthorne, Sr. She was raised in Highway 
Park, a rural African American community near the township 
of Lake Placid, Florida, which was developed by her father 
and his friends during the 1930s. Her father was a 
decorated World War II veteran. He worked hard as a land 
developer and builder to establish an income for self- 
employment. The late Mr. Hawthorne, Sr. served as a county 
leader on several Boards including hospitals, banks, and as 
a committee member for the Florida Home Loaners Association 
for Farmers and Florida's Fruit Growers Association. Her 
mother still lives at the family's homesite in Highway Park. 
Dorothy is a divorcee with one child, 16 -year-old 
Nathan 'ette Hazelle Burdine. 

Dorothy received her first eight years of education at 
George Washington Carver Elementary School, a racially 
segregated public school, located in Highway Park, an 
African American community. By 1964, the Civil Rights Act 
mandated public school integration of the races of people. 
After the courts ordered that all public schools would be 
racially integrated, Dorothy attended Lake Placid High 


School in 1965 as a freshman and graduated as a National 
Honors Student in 1970. In the Fall of 1970, Dorothy 
entered Florida A & M University in Tallahassee, Florida. 
She received a baccalaureate degree in nursing in 1974 and 
practiced neonatal and pediatric nursing at Georgia Baptist 
Hospital in Atlanta before returning to Florida to further 
her nursing education. Dorothy entered the University of 
Florida in 1975 as a Graduate Minority Fellow and completed 
her master's degree in pediatric nursing by August, 1977. 

For several years Dorothy taught pediatric nursing in 
four-year baccalaureate programs at major universities. She 
was instrumental in the development of a nursing clinic in 
Crawford, Mississippi as an assistant professor of nursing 
at Mississippi University for Women. She served as a 
nursing consultant for Morris Brown College in Atlanta, 
Georgia during the inception of their nursing program. She 
is a member of the National Nursing Honor Society, Sigma 
Theta Tau. 

Dorothy returned to Florida as a Graduate Minority 
Fellow for the University of Florida and an American Nurses 
Association Ethnic Minority Fellow; she commenced doctoral 
work in 1992. She plans to return to academic nursing after 
graduation and continue her interests in research, writing, 
and developing programs for early menarcheal girls of 
various racial and ethnic groups. 

I certify that I have read this study and that in my 
opinion it conforms to acceptable standards of scholarly 
presentation and is fully adequate, in scope and quality, as 
a dissertation for the degree of ppctor /bf Philosophy. 

Hossein N. Yarandi, Chairperson 
Associate Professor of Nursing 

I certify that I have read this study and that in my 
opinion it conforms to acceptable standards of scholarly 
presentation and is fully adequate, in scope and quality, as 
a dissertation for the degree of Doctor of Philosophy. 


Fays' Gary 

Distinguished ! ervice 
of Nursing 

I certify that I have read this study and that in my 
opinion it conforms to acceptable standards of scholarly 
presentation and is fully adequate, in scope and quality, as 
a dissertation for the degree of Doctor of Philosophy. 

Sharleen H. Simpfeon 

Associate Professor of Nursing 

I certify that I have read this study and that in my 
opinion it conforms to acceptable standards of scholarly 
presentation and is fully adequate, in scope and quality, as 
a dissertation for the degree of J^octor of Philosophy. 


yel)ix M. Berardo 
/professor of Sociology 

I certify that I have read this study and that in my 
opinion it conforms to acceptable standards of scholarly 
presentation and is fully adequate, in scope and quality, as 
a dissertation for the degree of Doctor of Philosophy. 


^g^- t yt^-y-> 

oe R. Feagin 
Graduate Research Professor 
of Sociology 

This dissertation was submitted to the Graduate Faculty 
of the College of Nursing and to the Graduate School and was 
accepted as partial fulfillment of the requirements for the 
degree of Doctor of Philosophy. 

August 1999 

Dean, College of Nursing/ 

^KfJAk- /L £j._ 

Dean, Graduate School